残余淋巴结短径与食管鳞癌放化疗疗效和预后相关性及Nomogram模型建立

Correlation of short diameter of residual lymph nodes with efficacy and prognosis in esophageal squamous cell carcinoma patients undergoing chemoradiotherapy and establishment of a Nomogram model

目的分析残余淋巴结短径与食管鳞癌放化疗疗效及预后之间相关性,并创建Nomogram模型来预测患者预后。方法收集淮安市第二人民医院自2018—2020年间行放化疗的143例食管鳞癌患者的临床资料,Kaplan-Meier法生存分析并log-rank检验和单因素预后分析,Cox模型多因素预后分析。通过建立Nomogram预测模型来预测食管鳞癌放化疗患者的1、2年无进展生存,并使用C-index、AUC及校准曲线来评估模型效能。结果Logistic回归分析结果表明分化程度、TNM分期、放疗前后的患者自评-主观全面评定(PG-SGA)评分及残余淋巴结短径是食管鳞癌放化疗患者疗效的独立预测因素。Cox回归分析结果表明分化程度、TNM分期、放疗前后的PG-SGA评分及残余淋巴结短径是食管鳞癌放化疗患者预后的独立预测因素。结论残余淋巴结短径与食管鳞癌放化疗疗效及预后显著相关,综合临床基线特征后所建立的Nomogram模型是预测患者预后的实用且可靠的工具。

Objective To analyze the correlation of the short diameter of residual lymph nodes with the efficacy and prognosis of patients with esophageal squamous cell carcinoma(ESCC)undergoing chemoradiotherapy(CRT),and establish a Nomogram prediction model to predict the prognosis of ESCC patients.Methods Clinical data of 143 ESCC patients who underwent CRT in Second People′s Hospital of Huai′an from August 2018 to September 2020 were collected.The survival analysis was conducted with Kaplan-Meier method,log-rank test and univariate prognostic analysis.Multivariate prognostic analysis was performed with Cox models.Finally,a Nomogram prediction model was established to predict the 1-year and 2-year progression-free survival(PFS)of patients,and the C-index,AUC,and calibration curve were used to evaluate the performance of the model.Results Logistic regression analysis results showed that differentiation,TNM staging,PG-SGA scores before and after radiotherapy(RT)and short diameter of residual lymph nodes were the independent predictors of clinical efficacy of ESCC patients treated with CRT.Cox regression analysis demonstrated that differentiation,TNM staging,PG-SGA scores before and after RT and short diameter of residual lymph nodes were the independent prognostic predictors of ESCC patients undergoing CRT.Conclusions The short diameter of residual lymph nodes is significantly correlated with the efficacy and prognosis of ESCC patients undergoing CRT.The Nomogram prediction model established after comprehensive clinical baseline characteristics is a practical and reliable tool for predicting clinical prognosis of ESCC patients.