Xelox方案术后化疗Ⅱ、Ⅲ期结肠癌患者 临床预后的列线图预测模型构建

The construction of a nomogram prediction model for the clinical prognosis of XELOX scheme with postoperative chemotherapy stage Ⅱ and Ⅲ colon cancer patients

目的通过收集大样本量的数据集资料,构建Ⅱ、Ⅲ期结肠癌患者术后Xelox方案化疗疗效预测的模型。方法通过电子病历系统筛选出采用Xelox化疗方案的Ⅱ、Ⅲ期结肠癌患者训练数据集1210例和验证数据集348例,进行Cox回归多因素分析,将多因素分析结构纳入构建列线图预测模型,并通过C-index和校正曲线对模型进行验证。结果年龄、细胞分化程度、肿瘤部位、神经侵犯、肿瘤T、N分期、淋巴结清扫数目、癌胚抗原(CEA)水平、基质金属蛋白酶-7(MMP-7)水平、血管内皮生长因子(VEGF)水平、新辅助化疗、Xelox方案化疗周期是患者总生存期(OS)的影响因素(P<0.05)。成功构建列线图预测模型,C-index检验训练集和验证集皆大于美国癌症联合委员会发布的第7版TNM系统(训练数据集C-index=0.728,验证数据集C-index=0.734),校正曲线中预测模型的预测结果与实际情况拟合较好。结论成功构建Ⅱ、Ⅲ期结肠癌患者Xdox方案术后化疗临床预后的列线图预测模型,对Xelox化疗疗效的预测具有很好的临床应用价值。

Objective To construct a model for predicting the curative effect of Xelox chemotherapy in patients with stage Ⅱ and Ⅲcolon cancer by collecting data from a large sample size.Methods Through the electronic medical record system,1,210 patients with stage Ⅱ and Ⅲ colon cancer training data set and 348 cases with validation data set were screened out using Xelox chemotherapy regimen.Cox regression multi-factor analysis was performed,and the multi-factor analysis structure was included in the construction of nomogram predictions model,and verify the model through C-indcx and calibration curve.Results Age,degree of cell differentiation,tumor location,nerve invasion,tumor T and N staging,number of lymph node dissection,carcinoembryonic antigen(CEA)level,matrix metalloproteinase-7(MMP-7)level,vascular endothelial growth factor(VEGF)Level,neoadjuvant chemotherapy,and Xelox regimen chemotherapy cycle are the influencing factors of patients'OS(P<0.05).The nomogram prediction model was successfully constructed.Both the C-index test training set and the validation set were larger than the 7th version of the TNM system released by the Joint Committee on Cancer(training data set C-index^O.728,validation data set C-index=0.734),The prediction result of the prediction model in the calibration curve fits well with the actual situation.Conclusion The nomogram prediction model for the clinical prognosis of patients with stage Ⅱ and Ⅲ colon cancer after Xelox regimen chemotherapy has been successfully constructed,which has a good clinical application value in predicting the efficacy of Xelox chemotherapy.