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基于列线图模型对视网膜母细胞瘤预后的临床预测

Clinical Prediction of Prognosis of Retinoblastoma Based on Nomogram

  • 摘要:
    目的 探讨影响视网膜母细胞瘤(RB)患者预后的相关独立危险因素,并构建列线图预测RB患者预后。
    方法 从美国监测、流行病学和结果数据库SEER数据库中收集了759例RB患者的数据,患者按照7:3比例随机分配到训练集和验证集。通过单变量、多变量Cox比例风险回归分析确定独立的预后因素,基于此构建列线图并对该模型进行预测效能评价。
    结果 与总生存期有关的独立风险因素为T分期和SEER分期。SEER训练集的C指数为0.765(95%CI: 0.744~0.786),绘制校正曲线重合较好,表明了其具有良好的一致性。ROC曲线显示,列线图可以准确预测RB患者3年(AUC=0.743)、5年(AUC=0.734)和10年(AUC=0.720)生存率。
    结论 T分期和SEER分期为RB患者预后相关的独立危险因素,列线图能准确预测患者3、5、10年总生存率。

     

    Abstract:
    Objective To investigate the independent risk factors affecting prognosis of patients with retinoblastoma (RB) and construct a nomogram to predict prognosis of patients with RB.
    Methods Data of 759 RB patients were collected from the SEER database. Patients were randomly assigned to the training group and validation group in a 7:3 ratio. Univariate and multivariate Cox proportional hazard regression analyses were used to determine the independent prognostic factors, based on which a nomogram was constructed. C index, calibration curve, and ROC curve were used to evaluate the predictive efficiency and calibration degree of the nomogram.
    Results Multivariate analysis identified independent risk factors associated with overall survival, namely, T stage and SEER stage. The C-index of SEER training set was 0.765 (95%CI: 0.744-0.786), the calibration curve was drawn, and the observed and predicted values overlapped well, indicating good consistency. The ROC curve showed that the nomogram could accurately predict three-year (AUC=0.743), five-year (AUC=0.734) and 10-year (AUC=0.720) survival rates of RB patients.
    Conclusion T stage and SEER stage are independent risk factors related to prognosis of RB patients, and the nomogram can accurately predict the three-year, five-year, and 10-year overall survival rates of patients.

     

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