可切除的肢端黑色素瘤预后影响因素分析及预测模型建立

发布时间：2018-04-11 00:32

本文选题：肢端黑色素瘤 + 炎症标志物　；参考：《中山大学学报(医学科学版)》2017年02期

【摘要】：【目的】探讨影响可切除的肢端黑色素瘤患者预后的危险因素,建立预测模型并验证其预测价值。【方法】回顾性分析2001年1月至2011年8月在中山大学肿瘤防治中心接受根治性手术切除的232例肢端黑色素瘤患者的临床病理特征及术前炎症指标,应用COX比例风险回归模型分析预后影响因素并在此基础上建立预测模型,采用Kaplan-Meier法绘制生存曲线并对组间差异进行log-rank检验,通过ROC曲线下面积(AUC)评价模型的预测准确度。【结果】通过COX比例风险回归模型分析显示年龄、LDH、肿瘤分期、球蛋白、CRP为影响患者预后的独立危险因素。根据回归系数β对以上五项因素赋值并计算每位患者的总评分,按照不同评分进行危险分级:低危组(0-2分)、中危组(3-5分)、高危组(6-9分),三组的5年总生存率分别为42.9%、25.7%和3.7%,各组的预后具有明显统计学差异(P0.001),预测模型ROC曲线下面积AUC:0.664(95%CI:0.599-0.724)。【结论】年龄、LDH、肿瘤分期及术前的球蛋白和CRP水平是影响可切除的肢端黑色素瘤患者预后的独立危险因素。新建立的预测模型能够较好的反应肢端黑色素瘤患者的预后,并且可对不同分期的患者按照危险度加以区分,是对TNM分期的有益补充,为临床进行分层个体化治疗和预后预测提供参考。
[Abstract]:[objective] to investigate the prognostic factors of resectable extremity melanoma.To establish a predictive model and verify its predictive value. [methods] A retrospective analysis of 232 patients with extremity melanoma underwent radical resection from January 2001 to August 2011 at the Cancer Center of Sun Yat-sen University was performed. [methods] Clinical and pathological features of 232 patients with extremity melanoma were analyzed retrospectively.Signs and preoperative inflammatory markers,The prognostic factors were analyzed by COX proportional risk regression model and the predictive model was established. The survival curve was drawn by Kaplan-Meier method and the difference between groups was tested by log-rank.The predictive accuracy of the model was evaluated by the area under the ROC curve. [results] the COX proportional risk regression analysis showed that age, tumor stage and globulin CRP were independent risk factors affecting the prognosis of the patients.According to the regression coefficient 尾, the above five factors were evaluated and the total score of each patient was calculated.According to the different scores, the risk grading was carried out: low risk group (0-2), moderate risk group (3-5 minutes), high risk group (6-9 minutes). The 5-year overall survival rate of the three groups was 42.9% and 3.7%, respectively. The prognosis of each group was significantly different (P 0.001), and the prediction model was under the ROC curve.[conclusion] Age, tumor stage and preoperative levels of globulin and CRP are independent risk factors for prognosis of resectable limb melanoma.The new prediction model can better reflect the prognosis of patients with limb melanoma, and can distinguish the patients with different stages according to their risk. It is a useful supplement to TNM staging.To provide a reference for stratified individualized treatment and prognosis prediction.
【作者单位】：中山大学肿瘤防治中心生物治疗中心;
【基金】：国家自然科学基金(81272341)
【分类号】：R739.5

【相似文献】