基于CD133及上皮-间质转化相关因子的列线图模型对上皮性卵巢癌预后的预测价值

The predict value of nomogram model based on CD133 and EMT related factors for the prognosis of epithelial ovarian cancer

目的构建预测上皮性卵巢癌(EOC)预后的列线图模型,验证其应用价值。方法对2009年1月至2012年1月十堰市太和医院152例经手术病理确诊的初治EOC病人进行术后持续随访。检测其病理标本中CD133、Snail、E-cadherin蛋白表达情况,统计病人一般资料及临床病理资料,通过Cox风险比例模型确定病人累积生存率的影响因素,应用R语言建立基于上述因素的列线图模型,并验证其应用价值。结果 152份病理标本中,CD133阳性表达87例,占57.24%,E-cadherin阳性表达50例,占32.89%,Snail阳性表达89例,占58.55%。CD133、Snail阳性者及E-cadherin阴性者,累积生存时间明显短于对应对照组,差异有统计学意义(P<0.05)。CD133阳性、伴腹部脏器或淋巴结转移是病人预后的危险因素,E-cadherin阳性是病人预后的保护因素(P<0.05)。经R语言建立列线图模型及校准曲线,校准图形接近于斜率为1的直线,列线图模型的内部一致性参数C-index=0.699。结论 CD133及E-cadherin表达情况是EOC病人预后的影响因素,构建列线图能够有效预测病人生存率。

Objective To build a nomogram model for the predicting of in from Shiyan Taihe Hospital January 2009 to Januany 2012,prognosis of epithelial ovarian cancer(EOC),and verify its value.Methods 152 patients with EOC newly diagnosed by histopathology in Shiyan Taihe Hospital from January 2009 to January 2012 were followed up continuously after operation.The expression of CD133,Snail,E-cadherin protein in tumor tissue were detected.Patients’ generalmaterials and clinical pathological data were counted.The influencing factors of cumulative survival rate were analyzed by Cox proportional hazard model.The proportional hazard model was drawn by R language to verify its application value.Results Among the 152 pathological specimens,87 cases were CD133 positive,accounting for 57.24%,50 cases were E-cadherin positive,accounting for 32.89%,and 89 cases were Snail positive,accounting for 58.55%.The cumulative survival time of the patients with CD133,Snail positive and E-cadherin negative were significantly shorter than that of the corresponding control group,the differences were statistically significant(P<0.05).CD133 positive,abdominal organ or lymph node metastasis were risk factors for prognosis,and E-cadherin positive was an protective factor for prognosis(P<0.05).The nomogram model and the calibration curve were established by R language,and the calibration curve was close to a straight line with slope near 1,C-index of this nomogram model was 0.699.Conclusion The expression of CD133 and E-cadherin expression were influencing factors affecting the prognosis of patients with EOC.Constructing nomograms can effectively predict the survival rate of the patients.