2011-2021年新疆癌症中心非小细胞肺癌患者预后分析

Prognostic analysis of non-small cell lung cancer patients in Xinjiang Cancer Center from 2011-2021

目的 分析影响新疆地区非小细胞肺癌(NSCLC)患者生存时间和预后的相关因素,构建NSCLC患者的预后预测模型。方法 收集2011-2021年新疆癌症中心(新疆医科大学附属肿瘤医院)9 577例NSCLC患者临床资料进行回顾性分析,采用单因素及多因素Cox比例风险回归模型分析NSCLC患者预后影响因素,并绘制不同因素的Kaplan-Meier生存曲线,采用列线图实现结果可视化。使用受试者工作特征(ROC)曲线进行模型验证,C指数评估模型性能。结果 9 577例NSCLC患者中,汉族患者占85.26%;女性(39.14%)少于男性(60.86%);年龄<60岁患者占41.27%;临床分期以Ⅳ期为主(52.09%),其次为Ⅲ期(23.06%)、Ⅰ期(18.45%)和Ⅱ期(6.40%);临床病理学分型主要为腺癌(62.92%)和鳞癌(22.31%);NSCLC的原发位置多发于右肺(58.48%);职业分布中学生、专业技术人员和企业管理者等职业较少。单因素分析结果显示,确诊年龄、性别、种族、TNM分期、T分期、N分期、M分期、病理组织学类型以及原发肿瘤位置等与NSCLC患者预后有统计学关联,其χ^(2)值分别为160.21、37.84、294.77、1 993.09、796.44、1 537.08、1 515.03、178.04和17.55,均P<0.01。基于上述预后影响因素构建Cox比例风险回归模型,绘制1、3、5和7年总生存期模型。1、3、5年的总生存预测模型的曲线下面积分别为0.701、0.784和0.772。绘制的校准曲线靠近理想的45°参考线,显示了列线图的良好预测性能。结论 构建的列线图和总生存预测模型在新疆地区NSCLC患者生存和预后方面有很好的预测价值,有助于评估患者生存期并为临床制定治疗方案提供重要参考,延长患者生存期。

Objective To analyze the relevant factors that affect the survival time and prognosis of non-small cell lung cancer(NSCLC) patients in Xinjiang region,and construct a prognosis prediction model for NSCLC patients.Methods A total of 9 577 NSCLC patients from the Xinjiang Cancer Center(Affiliated Oncology Hospital of Xinjiang Medical University) from 2011 to 2021 were collected for retrospective analysis.Univariate and multivariate Cox proportional risk regression models were used to analyze the prognostic factors of NSCLC patients,and Kaplan-Meier survival curves for different factors were plotted.Column charts were used to visualize the results.Used the receiver operating characteristic(ROC) curve for model validation,and evaluated model performance with the C index.Results Among 9 577 NSCLC patients,Han nationality patients accounted for 85.26%,women(39.14%) were less than men(60.86%),41.27% of patients aged<60 years old,the clinical staging was mainly stage Ⅳ(52.09%),followed by stage Ⅲ(23.06%),stage Ⅰ(18.45%),and stage Ⅱ(6.40%).The main types of clinical pathology were adenocarcinoma(62.92%) and squamous cell carcinoma(22.31%).The primary location of NSCLC was mostly in the right lung(58.48%).There were relatively few professions such as middle school students,professional technicians,and enterprise managers in terms of occupational distribution.The results of univariate analysis showed that age,gender,race,TNM stage,T stage,N stage,M stage,pathological tissue type,and primary tumor location were statistically correlated with the prognosis of NSCLC patients,the χ^(2) values were 160.21,37.84,294.77,1 993.09,796.44,1 537.08,1 515.03,178.04and 17.55,respectively,all P<0.01.Based on the aforementioned prognostic factors,constructed a Cox proportional risk regression model and draw a 1-year,3-year,5-year and 7-year overall survival model.The area under the curve of the 1-year,3-year and 5-year total survival prediction models was 0.701,0.784 and 0.772,respectively.The calibration curve plotted was close to the ideal 45°reference line,demonstrating the good predictive performance of the nomogram.Conclusion The constructed column chart and overall survival prediction model have good predictive value in the survival and prognosis of NSCLC patients in Xinjiang,helping to evaluate patient survival and provide important references for clinical treatment plans,and extending patient survival.