| 冯嵩崴,罗山晖,马云,朱维培.基于列线图方法探究LODDS分级对行满意减瘤术后卵巢癌患者的预后价值.[J].中南医学科学杂志.,2021,(1):5-11. |
| 基于列线图方法探究LODDS分级对行满意减瘤术后卵巢癌患者的预后价值 |
| Prognostic value of LODDS grade in patients with ovarian cancer after satisfactory cytoreduction based on the method of nomogram |
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| DOI：10.15972/j.cnki.43-1509/r.2021.01.002 |
| 中文关键词: LODDS分级 卵巢癌 肿瘤细胞减灭术后 预测模型 SEER数据库 |
| 英文关键词:LODDS grade ovarian cancer cytoreductive surgery prediction model SEER database |
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| 中文摘要: |
| 目的探讨已行满意减瘤术后的卵巢癌患者淋巴结阳性数与阴性数对数(LODDS)的预后价值,并基于LODDS等级建立列线图模型。 方法收集SEER数据库中3 968例行满意减瘤术且术中行淋巴结活检或系统淋巴结清扫的卵巢癌患者的临床资料。采用时间依赖的COX回归分析筛选独立预后因素,并建立预测模型。使用一致性指数(C-index)及校正曲线在建模组及验证组中评价模型的可靠性。使用ROC曲线比较两组使用LODDS分级列线图和单独使用FIGO分期方法预测患者生存率的准确性。 结果Cox单因素回归分析显示年龄、种族、婚姻状态、肿瘤位置、肿瘤分化程度、肿瘤病理类型、FIGO分期、LODDS分级、化疗情况以及CA125情况是潜在的危险因素。Cox多因素回归分析显示年龄、婚姻状态、肿瘤分化程度、肿瘤病理类型、FIGO分期、LODDS分级是独立影响因素,并以此建立列线图。建模组中,列线图C-index为0.752,预测1、3、5年生存率ROC曲线的AUC值均优于单独使用FIGO分期。验证组中,列线图C-index为0.747,预测1、3、5年生存率ROC曲线的AUC值同样优于单独使用FIGO分期。 结论LODDS分级是行满意减瘤术后卵巢癌患者的独立预后因素。术后以基于LODDS分级的列线图预测患者1、3、5年生存率较单纯使用FIGO分期更为准确。 |
| 英文摘要: |
| Aim To investigate the prognostic value of log odds of metastatic lymphnodes (LODDS) in patients with ovarian cancer who have undergone satisfactory cytoreduction surgery, and to establish a nomogram model based on the LODDS grade. MethodsThe clinical data of 3968 patients with ovarian cancer who underwent satisfactory cytoreductive surgery and intraoperative lymph node biopsy or systemic lymph node dissection in the SEER database were collected. Time-dependent Cox regression analysis was used to screen independent prognostic factors and establish a predictive model. Use the C-index and calibration curve to evaluate the reliability of the model in the modeling group and the verification group. The ROC curve was used to compare the accuracy of the modeling group and the LODDS grade nomogram in the modeling group and the FIGO staging alone to predict the accuracy of patients' 1,3, and 5 year survival rates. ResultsCox univariate regression analysis showed that age, race, marital status, tumor location, tumor grade, tumor pathological type, FIGO staging, LODDS grade, chemotherapy status, and CA125 status were potential risk factors. Cox multivariate regression analysis showed that age, marital status, tumor grade, tumor pathological type, FIGO staging and LODDS grade were independent influencing factors. Subsequently, the nomogram was drawn.In the modeling group, the C-index of the nomogram was 0.752, and the AUC values of the ROC curve for predicting 1,3, and 5 year survival rates precede FIGO staging. In the validation group, the C-index of the nomogram was 0.742, and the AUC values of the ROC curve for predicting 1,3, and 5-year survival rates precede FIGO staging. ConclusionLODDS grade is an independent prognostic factor for patients with ovarian cancer after satisfactory cytoreductive surgery. It is more accurate to predict the 1,3, and 5 year survival rate of patients by the nomogram based on the LODDS grade than the FIGO staging alone. |
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