基于SEER数据库脊柱骨肉瘤预后预测模型列线图的建立

Establishment of a Nomogram for Predicting the Prognosis of Spinal Osteosarcoma Based on SEER Database

目的基于美国国立癌症研究所的监测、流行病学和结果(National Cancer Institute,The Surveillance,Epidemiology,and End Results Program,SEER)数据库患者数据构建列线图,预测原发性脊柱骨肉瘤患者的3年及5年总生存率。方法在SEER数据库中收集符合纳入、排除标准的原发性脊柱骨肉瘤患者237例,利用单因素和多因素的COX回归筛选独立危险因素,并绘制预测原发性脊柱骨肉瘤患者总生存率的列线图,使用一致性指数(C-index),受试者工作特征(relative operating characteristic curve,ROC)曲线和校准图对列线图进行内部验证。结果年龄、肿瘤转移情况与是否化疗为影响脊柱骨肉瘤患者预后的独立危险因素(P <0.05)。列线图的C指数为0.677(95%CI:0.643~0.711),患者3年和5年总生存率的ROC曲线下面积分别为0.645与0.737,校准曲线显示良好的一致性。结论利用SEER数据库构建了预测原发性脊柱骨肉瘤预后的列线图,可为患者提供较准确和个性化的生存预测。

Objective Based on data from the SEER database,a nomogram was constructed to predict 3 years and 5 years overall survival in patients with primary spinal osteosarcoma.Methods A total of 237 patients with primary spinal osteosarcoma who met the inclusion and exclusion criteria were collected from the SEER database.Univariate and multivariate COX were used to determine the independent prognostic factors in the study cohort.A nomogram was drawn to predict the overall survival in patients with primary spinal osteosarcoma.The consistency index(C-index),relative operating characteristic curve and calibration curve were used to verify the internal validation of the nomogram and check its prediction accuracy.Results Age,tumor metastasis and chemotherapy were independent risk factors for the prognosis of patients with spinal osteosarcoma(P<0.05).The C index of the nomogram was 0.677(95%CI:0.643-0.711).The area under the ROC curve of the 3 years and 5 years overall survival was 0.645 and 0.737,respectively.The calibration curve showed good consistency.Conclusion SEER database was used to construct a nomogram that predicted the prognosis of primary spinal osteosarcoma,providing a more accurate and personalized survival prediction for patients.