摘要
目的探讨远端胆管癌患者术后生存的预后因素并构建列线图模型。方法回顾性分析2013年1月至2022年7月该院收治的行手术治疗的74例远端胆管癌患者的临床病理资料,采用多因素Cox回归进行独立危险因素分析,应用Kaplan-Meier法进行生存分析,运用R软件构建列线图预测模型,并采用一致性指数(C-index)、受试者工作特征曲线下面积(AUC)和校正曲线验证预测模型的效能。结果74例患者中位总体生存(OS)为18.9个月,术后1、3、5年OS率分别为63.6%、37.8%和28.1%。多因素Cox回归分析结果显示,术前CA19-9水平高、T分期晚、淋巴结清扫总数<10个及术中出血量多是dCCA患者术后预后不良的独立危险因素(P<0.05)。基于以上独立危险因素构建的列线图预测模型,C-index为0.775,预测术后1、3、5年OS率的AUC分别为0.800、0.841、0.919。结论构建的列线图模型预测效能较好。
Objective To investigate the prognostic factors and to construct a nomogram in patients with distal cholangiocarcinoma(dCCA)after surgery.Methods The clinicopathological data of patients with distal cholangiocarcinoma who underwent surgery in the hospital from January 2013 to July 2022 were retrospectively analyzed.Multivariate Cox regression was used for independent risk factor analysis,and Kaplan-Meier method was used for survival analysis.The nomogram was constructed by R software.The accuracy and discrimination of the nomogram was validated by C-index,area under the receiver working curve(AUC)and calibration curve.Results The median overall survival(OS)was 18.9 months.The first year,third year and fifth year OS rates were 63.6%,37.8%and 28.1%,respectively.Multivariate Cox regression analysis showed that preoperative higher CA19-9 level,later tumor T stage,total number of lymph nodes<10 and more intraoperative blood loss were independent risk factors for poor postoperative prognosis in dCCA patients(P<0.05).The C-index of the nomogram constructed based on the above independent risk factors was 0.775,and the AUC for predicting the first year,third year and fifth year OS rates were 0.800,0.841 and 0.919,respectively.Conclusion The constructed nomogram in this study has good prediction efficiency.
作者
赵令
任翱
李伟
秦琼
彭秋风
马瑞东
罗诗樵
ZHAO Ling;REN Ao;LI Wei;QIN Qiong;PENG Qiufeng;MA Ruidong;LUO Shiqiao(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
CAS
2023年第17期2615-2620,共6页
Chongqing medicine
基金
重庆医科大学附属第一医院培育基金项目(PYJJ2021-01)。
关键词
远端胆管癌
手术治疗
预后因素
列线图模型
生存分析
distal cholangiocarcinoma
surgical treatment
prognostic factors
nomogram
survival analysis
