消化道恶性肿瘤患者预后影响因素分析和预测模型的构建

Analysis of prognostic risk factors for gastrointestinal malignancy and establishment of predictive models

目的:分析消化道恶性肿瘤患者预后的影响因素,并建立和探讨生存预测模型的临床应用价值。方法:回顾性分析2015年1月至2016年5月肇庆医学高等专科学校附属医院和肇庆市中医院收治的200例消化道恶性肿瘤患者的病历资料,选择可能对预后产生影响的独立危险因素,应用诺模图模型分析影响预后的因素,根据临床决策曲线对模型进行评价。结果:COX回归分析显示,年龄、肿瘤分化程度、肿瘤分期、手术史和术前化疗均为消化道恶性肿瘤患者2.5年生存率的独立影响因素(均P<0.05)。诺模图预测消化道恶性肿瘤患者的2.5年死亡率为40%时,提前对该患者进行治疗干预,可能会有约38%的患者受益。结论:年龄、肿瘤分化程度、肿瘤分期、手术史和术前化疗与消化道恶性肿瘤患者的预后有关,根据这些影响因素构建的诺模图可量化评估患者的预后。

Objective: To analyze the prognostic factors for gastrointestinal malignancy,and to investigate the value of a survival prediction model. Methods: The clinical data from 200 patients with digestive tract tumor from January 2015 to May 2016 in our hospital were retrospectively analyzed.The independent risk factors were screened and the nomogram model was established according to the screened factors. Results: COX multivariate analysis showed that the independent factors related to prognosis were age,tumor differentiation degree,tumor stage,operation history and preoperative chemotherapy.When nomogram predicted a 2.5-year mortality rate of 40% for patients with gastrointestinal malignancies,early treatment may benefit 38% of patients. Conclusion: The nomogram model established according to the age,tumor differentiation degree,tumor stage,operation history and preoperative chemotherapy could quantitatively predict the 2.5-year mortality of gastrointestinal malignancy.