| 张海玲.影响早期食管癌患者淋巴结转移的危险因素：预测性列线图的开发和验证[J].肿瘤学杂志,2023,29(4):294-299. |
| 影响早期食管癌患者淋巴结转移的危险因素：预测性列线图的开发和验证 |
| Development and Validation of Nomogram for Predicting Lymph Node Metastasis in Patients with Early Esophageal Cancer |
| 投稿时间：2022-06-01 |
| DOI：10.11735/j.issn.1671-170X.2023.04.B007 |
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| 中文关键词: 早期食管癌 列线图 淋巴结转移 |
| 英文关键词:early esophageal cancer nomogram lymph node metastasis |
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| 中文摘要: |
| 摘 要：［目的］ 开发和验证一个列线图，以预测早期食管癌患者的淋巴结转移。［方法］ 在临床病理证实的早期食管癌患者中建立一个预测模型。2014年1月至2017年12月期间272例因pT1期食管癌行食管切除术的患者纳入训练队列，114例于2018年1月至2019年12月因pT1期食管癌行食管切除术的患者纳入验证队列 。纳入的指标有年龄、性别、肿瘤的位置、肿瘤大小、组织学分级、组织学类型和淋巴结转移。采用二元Logistic回归模型评估淋巴结转移的危险因素。利用多因素分析的结果，建立了预测淋巴结转移的列线图。Hosmer-Lemeshow试验用于评估拟合优度，Harrell一致性指数（C指数）和ROC曲线下面积评价列线图的预测性能。［结果］ 与淋巴结转移相关的两个变量为肿瘤大小（OR=13.685，95%CI：4.216～44.425；P<0.001）和组织学分级（OR=23.289，95%CI：7.659～70.819，P<0.001）。训练队列（272例患者）的C指数为0.95（95%CI：0.93～0.97），ROC曲线下面积0.966；验证队列（114例患者）的C指数为0.91（95%CI：0.88～0.94），ROC曲线下面积0.950。［结论］ 早期食管癌的列线图可以有效预测淋巴结转移的风险。 |
| 英文摘要: |
| Abstract：［Objective］ To develop and validate a nomogram to predict lymph node metastasis in patients with early esophageal cancer. ［Methods］ A total of 386 patients who underwent esophagectomy for pT1 esophageal cancer in Shijiazhuang People’s Hospital were enrolled in the study， including 272 cases admitted from January 2014 to December 2017 in training cohort and 114 cases admitted from January 2018 to December 2019 in validation cohort. The clinical data of patients， including age， gender， tumor location， tumor size， histological grade， histological type and lymph node metastasis were collected. Binary logistic regression model was used to evaluate the risk factors of lymph node metastasis. Based the risk factors a nomogram was established to predict lymph node metastasis. Hosmer-Lemeshow test was used to evaluate the goodness of fit， Harrell consistency index(C index) and the area under the ROC curve were used to evaluate the predictive performance of the nomogram. ［Results］ The logistic analysis showed that tumor size(OR=13.685， 95% CI： 4.216～44.425， P<0.001) and histological grade(OR=23.289， 95%CI： 7.659～70.819， P<0.001) were independent risk factors for lymph node metastasis in training cohort. The C index of the nomogram in the training cohort was 0.95(95%CI： 0.93～0.97)， and the area under the ROC curve was 0.966. The C index of the nomogram in the validation cohort was 0.91(95%CI： 0.88～0.94)， and the area under the ROC curve was 0.950. ［Conclusion］ A prediction nomogram has been developed in the study， which can effectively predict the risk of lymph node metastasis in patients with early esophageal cancer. |
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