早发性结直肠癌患者死亡竞争风险模型的构建

Construction of a mortality competition risk model for patients with early-onset colorectal cancer

  • 摘要:
    目的 分析早发性结直肠癌(EOCRC)患者发生肿瘤特异性死亡(CSM)的危险因素, 建立死亡风险预测模型并进行验证。
    方法 纳入监测、流行病学和最终结果(SEER)数据库2010—2019年经病理确诊的EOCRC患者14 554例, 并随机分成训练集10 188例及验证集4 366例。使用Fine-Gray竞争风险模型进行单因素及多因素分析,筛选EOCRC患者CSM率的影响因素; 建立预后预测模型,使用C指数、校准曲线进行内部验证,并绘制列线图。
    结果 病理类型、N分期、M分期、原发灶手术、区域淋巴结手术、远处转移灶手术及癌胚抗原(CEA)是EOCRC患者CSM率的独立影响因素(P < 0.05)。列线图模型的C指数接近0.8, 校准曲线贴合参考线。
    结论 本研究建立的EOCRC患者死亡竞争风险模型具有良好的预测价值,可以用于临床实践。

     

    Abstract:
    Objective To analyze the risk factors of cancer-specific mortality (CSM) in patients with early-onset colorectal cancer (EOCRC), and to establish and verify the mortality risk prediction model.
    Methods A total of 14 554 patients pathologically diagnosed with EOCRC from 2010 to 2019 were included in the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into a training set with 10 188 patients and a validation set with 4 366 patients. Fine-Gray competitive risk model was used for univariate and multivariate analysis, and influencing factors of CSM rate in patients with EOCRC were screened. The prognostic model was established, the C index and calibration curve were used for internal verification, and the column graph was drawn.
    Results Pathological type, N stage, M stage, primary lesion surgery, regional lymph node surgery, distant metastasis surgery and carcinoembryonic antigen (CEA) were independent factors influencing the CSM rate of EOCRC patients (P < 0.05). The C-index of the line graph model was close to 0.8, and the calibration curves fitted the reference line.
    Conclusion The death competition risk model of EOCRC patients established in this study has good predictive value and can be used in clinical practice.

     

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