接受根治性膀胱切除术的NMIBC患者癌症特异性生存期预测诺莫图的构建和验证
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Construction and validation of a cancer-specific survival prediction nomo-gram for NMIBC patients undergoing radical cystectomy
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    摘要:

    目的:探索改良淋巴结比率(mLNR)的预后价值,并构建模型用以预测根治性膀胱切除术(RC)后非肌肉浸润性膀胱癌(NMIBC)患者的癌症特异性生存期(CSS)。方法:将符合条件的NMIBC患者按7∶3的比例分为训练队列(n=651)和验证队列(n=280)。采用单变量和多变量Cox回归分析,通过逐步回归筛选独立预测因子,检查变量之间是否存在多重共线性,然后创建并验证预测CSS的诺莫图。通过Kaplan-Meyer生存分析和对数秩检验对所开发的风险分类系统进行检验。结果:年龄、婚姻状况、N分期、放疗和mLNR是NMBIC患者CSS的独立预后因素。训练队列的诺莫图C指数为0.706 (95%CI:0.661~0.751)。在训练队列中,预测1年、5年和10年CSS的曲线下面积(AUC)分别为0.799、0.736和0.732;在验证队列中,预测1年、5年和10年CSS的AUC分别为0.543、0.703和0.668。结论:mLNR是一个新的独立预后指标,基于该指标开发的预后模型对1、5、10年CSS的预测结果略优于AJCC分期系统,有利于丰富癌症的预后指标。

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    Objective:To explore the prognostic value of modified lymph node ratio(mLNR)and to construct a model to predict cancer-specific survival(CSS)in patients with non-muscle-invasive bladder cancer(NMIBC)after radical cystectomy(RC).Meth-ods:Eligible NMIBC patients were randomized in a 7∶3 ratio into a training group(n=651)and a validation group(n=280).Univa-riate and multivariate Cox regression analyses were used to screen for independent predictors by stepwise regression and to check for multicollinearity between variables,and then nomograms predicting CSS were created and validated.The developed risk classification system was tested by Kaplan-Meyer survival analysis and log-rank test.Results:Age,marital status,N-staging,radiotherapy and mLNR were independent prognostic factors for CSS in patients with NMBIC.The nomogram C index for the training cohort was 0.706(95%CI:0.661~0.751).In the training cohort,the AUCs for predicting 1,5,and 10 years CSS were 0.799,0.736,and 0.732,respectively.In the validation cohort,the AUCs for predicting 1,5,and 10 year CSS were 0.543,0.703,and 0.668,respectively.Conclusion:The mLNR is a new independent prognostic indicator,and the prognostic model developed based on it predicted 1,5,and 10 year CSS slight-ly better than the AJCC staging system,which is conducive to the enrichment of prognostic indicators for cancer.

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王捷;赵栖;刘贵喜;蒋小雷;李家兵;.接受根治性膀胱切除术的NMIBC患者癌症特异性生存期预测诺莫图的构建和验证[J].川北医学院学报,2025,40(4):522-529.

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  • 在线发布日期: 2025-07-24
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