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Secondary prevention for intracranial atherosclerotic stenosis: Where we stand and challenges ahead. 颅内动脉粥样硬化性狭窄的二级预防:我们的立场和未来的挑战。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0037
Wanwan Zhang, Erlan Yu, Wenbo Zhao, Chuanjie Wu, Xunming Ji
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引用次数: 0
Prospects for the application of artificial intelligence in geriatrics. 人工智能在老年病学中的应用前景。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0034
Li Zhang, Jing Li
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引用次数: 0
A Notch signaling pathway-related gene signature: Characterizing the immune microenvironment and predicting prognosis in hepatocellular carcinoma. Notch信号通路相关基因标记:表征肝细胞癌的免疫微环境和预测预后
IF 7.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0020
Qingmiao Shi, Shuwen Jiang, Yifan Zeng, Xin Yuan, Yaqi Zhang, Qingfei Chu, Chen Xue, Lanjuan Li

Background and objectives: Prior studies have highlighted an escalating global burden of hepatocellular carcinoma (HCC). The Notch signaling pathway regulates the initiation and development of HCC and determines the HCC prognosis.

Methods: The expression data of genes related to the Notch signaling pathway were acquired from public databases. To filter prognostic gene signatures and establish the risk model, the analyses of consensus clustering, least absolute shrinkage and selection operator (LASSO), and multivariate Cox were conducted. Subsequently, the risk stratification was optimized using a decision tree and nomogram. The immune landscapes were revealed utilizing the single-sample gene set enrichment analysis, and tumor immune dysfunction and exclusion score.

Results: According to the mRNA expression profile of Notch signaling pathway-related genes, HCC patients were stratified to three clusters, which have different survival probability and immune infiltration characteristic. Subsequently, we developed a risk model based on five prognostic Notch signaling-related gene signatures (SPP1, SMG5, HMMR, PLOD2, and CFHR4). The model demonstrated an accurate estimation of overall survival, revealing alterations in immune status and immunotherapy sensitivity among HCC patients with different risk scores.

Conclusions: This study constructed a Notch signaling pathway-related prognostic model, offering valuable insights for the assessment of immune characteristics and immunotherapy responses in HCC patients.

背景和目的:先前的研究强调了肝细胞癌(HCC)的全球负担不断上升。Notch信号通路调控HCC的发生和发展,并决定HCC的预后。方法:从公共数据库获取Notch信号通路相关基因的表达数据。为了筛选预后基因特征并建立风险模型,我们进行了共识聚类分析、最小绝对收缩和选择算子(LASSO)分析和多变量Cox分析。随后,利用决策树和nomogram对风险分层进行了优化。利用单样本基因集富集分析、肿瘤免疫功能障碍和排斥评分揭示免疫景观。结果:根据Notch信号通路相关基因的mRNA表达谱,将HCC患者分为3个簇,这些簇具有不同的生存概率和免疫浸润特征。随后,我们基于5个与Notch信号相关的预后基因特征(SPP1、SMG5、HMMR、PLOD2和CFHR4)建立了风险模型。该模型显示了对总生存率的准确估计,揭示了不同风险评分的HCC患者免疫状态和免疫治疗敏感性的变化。结论:本研究构建了Notch信号通路相关的预后模型,为评估HCC患者的免疫特性和免疫治疗反应提供了有价值的见解。
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引用次数: 0
Intratumoral microbiota in orchestrating cancer immunotherapy response. 肿瘤内微生物群在协调癌症免疫治疗反应中的作用。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0038
Yutian Zou, Hanqi Zhang, Feng Liu, Zhe-Sheng Chen, Hailin Tang
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引用次数: 0
Computational analyses to reveal the key determinants of the high malignancy level of cholangiocarcinoma. 计算分析揭示了胆管癌高恶性程度的关键决定因素。
IF 7.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0033
Xuan Li, Aoran Liu, Xuechen Mu, Zhihang Wang, Jun Xiao, Yinwei Qu, Zhenyu Huang, Ye Zhang, Ying Xu

Background and objectives: Cholangiocarcinoma (CHOL) is a rare and highly aggressive cancer that originates in the bile duct; it has an average five-year survival rate of 9%, which makes it the cancer with the lowest survival rate among all 33 cancer types in the cancer genome atlas (TCGA) Program. The aim of this study is to elucidate the key determinants of the high malignancy level of CHOL through computational and cell-based experimental approaches and, particularly, to investigate how bile acids (BAs) influence CHOL's propensity to metastasize.

Methods: Our study analyzed the transcriptomic data from 1835 tissue samples of 7 digestive system cancer types in the TCGA database and compared them with those of 330 control tissue samples. Multiple cellular and molecular factors were considered in the study, including the level of hypoxia, level of immune cell infiltration, degree of cellular dedifferentiation, and level of sialic acid (SA) accumulation on the surface of cancer cells. Using these factors, we developed a multivariable regression model for the five-year survival rate, as reported by the Surveillance, Epidemiology, and End Results (SEER) Program reports, and analyzed how BA biology influences a few of these factors and causes CHOL to have a high malignancy level.

Results: CHOL exhibited the highest level of SA accumulation and B-cell infiltration among all cancer types studied. BAs inhibit the cell cycle progression through the receptor GPBAR1, thereby limiting the rate of nucleotide biosynthesis-which in turn forces the cells to increase SA biosynthesis in order to maintain the intracellular pH at a stable level-thereby driving cell migration and metastasis, as established in our previous study.

Conclusions: BAs are the key contributors to the lowest five-year survival rate of CHOL among the seven cancer types studied here. This finding not only reveals the molecular mechanisms underlying the high malignancy level of CHOL but also provides a new potential target for the diagnosis and treatment of CHOL.

背景和目的:胆管癌(CHOL)是一种罕见且高度侵袭性的肿瘤,起源于胆管;它的平均五年生存率为9%,这使得它成为癌症基因组图谱(TCGA)计划中所有33种癌症类型中存活率最低的癌症。本研究的目的是通过计算和基于细胞的实验方法阐明CHOL高恶性水平的关键决定因素,特别是研究胆汁酸(BAs)如何影响CHOL的转移倾向。方法:本研究分析了TCGA数据库中7种消化系统癌症类型的1835份组织样本的转录组学数据,并与330份对照组织样本进行了比较。本研究考虑了多种细胞和分子因素,包括缺氧水平、免疫细胞浸润水平、细胞去分化程度、癌细胞表面唾液酸(SA)积累水平等。根据监测、流行病学和最终结果(SEER)项目报告,利用这些因素,我们建立了一个五年生存率的多变量回归模型,并分析了BA生物学如何影响其中一些因素并导致CHOL具有高恶性水平。结果:在所有癌症类型中,CHOL表现出最高水平的SA积累和b细胞浸润。BAs通过受体GPBAR1抑制细胞周期进程,从而限制核苷酸的生物合成速率,这反过来迫使细胞增加SA的生物合成,以维持细胞内pH稳定,从而驱动细胞迁移和转移,正如我们之前的研究所证实的那样。结论:在本研究的7种癌症类型中,BAs是导致CHOL 5年生存率最低的关键因素。这一发现不仅揭示了CHOL高恶性程度的分子机制,也为CHOL的诊断和治疗提供了新的潜在靶点。
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引用次数: 0
Effectiveness and safety of Qixuekang Oral Liquid on vascular health. 七血康口服液对血管健康的有效性和安全性。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0036
Shantong Jiang, Hongyan Shi, Yanqing Hu, Ning Zhang, Hongyu Wang
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引用次数: 0
Gene therapy in polycystic kidney disease: A promising future. 多囊肾病的基因治疗:前景光明。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0021
Cheng Xue, Jiayi Lv, Bo Yang, Shuqin Mei, Jing Xu, Xinming Li, Liming Zhang, Zhiguo Mao

Polycystic kidney disease (PKD) is a genetic disorder marked by numerous cysts in the kidneys, progressively impairing renal function. It is classified into autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD), with ADPKD being more common. Current treatments mainly focus on symptom relief and slowing disease progression, without offering a cure. Recent advancements in gene editing technologies, such as CRISPR-Cas9, have introduced new therapeutic possibilities for PKD. These approaches include miR-17 antisense oligonucleotides, adenovirus-mediated gene knockdown, Pkd1 gene or polycystin -1 C-terminal tail enhancement therapy, and 3-UTR miR-17 binding element by CRISPR-Cas9, which have shown potential in animal models and early clinical trials. Specifically for ARPKD, strategies like antisense oligonucleotide therapy targeting c-myc and CRISPR/ Cas9 knockdown of the P2rx7 gene have shown promise. Despite facing challenges such as technological limitations, ethical and legal issues, and high costs, gene therapy presents unprecedented hope for PKD treatment. Future interdisciplinary collaboration and international cooperation are essential for developing more effective treatment strategies for PKD patients.

多囊肾病(PKD)是一种遗传性疾病,以肾脏中大量囊肿为特征,逐渐损害肾功能。多囊肾病分为常染色体显性多囊肾病(ADPKD)和常染色体隐性多囊肾病(ARPKD),其中以ADPKD更为常见。目前的治疗主要集中在缓解症状和减缓疾病进展,而没有提供治愈。基因编辑技术的最新进展,如CRISPR-Cas9,为PKD的治疗带来了新的可能性。这些方法包括miR-17反义寡核苷酸、腺病毒介导的基因敲低、Pkd1基因或多囊蛋白-1 c末端尾增强治疗、CRISPR-Cas9的3-UTR miR-17结合元件,这些方法在动物模型和早期临床试验中显示出潜力。特别是对于ARPKD,针对c-myc的反义寡核苷酸治疗和CRISPR/ Cas9敲低P2rx7基因等策略已经显示出希望。尽管面临着技术限制、伦理和法律问题以及高昂的成本等挑战,基因治疗为PKD的治疗带来了前所未有的希望。未来的跨学科合作和国际合作对于制定更有效的PKD患者治疗策略至关重要。
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引用次数: 0
Artificial intelligence for disease X: Progress and challenges. 疾病X的人工智能:进展与挑战。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2024-0035
Keda Chen, Jiaxuan Li, Lanjuan Li
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引用次数: 0
Association of life's essential 8 with prevalence and all-cause mortality of chronic kidney disease among US adults: Results from the National Health and Nutrition Examination Survey (2015-2018). 生活必需品与美国成年人慢性肾病患病率和全因死亡率的关系:2015-2018年国家健康与营养检查调查结果
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2023-0119
Wei Chen, Yuanjun Tang, Yachen Si, Boxiang Tu, Fuchuan Xiao, Xiaolu Bian, Ying Xu, Yingyi Qin

Background and objectives: The association between chronic kidney disease (CKD) and cardiovascular disease has been previously evaluated. This study aimed to evaluate the association between the American Heart Association's Life's Essential 8 (LE8) and the prevalence and all-cause mortality of CKD in a nationally representative population of adults in the US.

Methods: This retrospective analysis included participants from the National Health and Nutrition Examination Survey spanning 2015-2018. We used multivariable survey logistic regression model to calculate the adjusted odds ratios (AORs) of the LE8 score for the prevalence of CKD. Survey-weighted Cox proportional hazards models were used to calculate the adjusted hazards ratios (AHRs) of the LE8 score for the risk of all-cause mortality among participants with CKD.

Results: Of the 8907 included participants, 789 had stage 3 to 5 CKD, and 8118 were in the non-CKD group. The adjusted prevalence rate of CKD was 10.7% in the low LE8 score group, and lower in the moderate (7.9%) and high (7.7%) LE8 score groups. Compared with low LE8 scores, moderate LE8 score (adjusted odds ratio [AOR] 0.628, 95% confidence interval [CI]: 0.463 to 0.853, P = 0.004) and high LE8 scores (AOR 0.328, 95% CI: 0.142 to 0.759, P = 0.011) were associated with lower prevalence rates of CKD. A similar association was found for health factors scores. Additionally, an increase in the LE8 score was associated with a lower risk of all-cause mortality (adjusted hazard ratio [AHR] 0.702, 95% CI: 0.594 to 0.829, P < 0.001).

Conclusion: The results of this study suggest the association of higher LE8 and its subscale scores with a lower prevalence and all-cause mortality of CKD.

背景和目的:慢性肾脏疾病(CKD)和心血管疾病之间的关联已经被评估过。本研究旨在评估美国心脏协会的生命基本8 (LE8)与美国全国代表性成人CKD患病率和全因死亡率之间的关系。方法:本回顾性分析纳入了2015-2018年全国健康与营养检查调查的参与者。我们使用多变量调查logistic回归模型来计算LE8评分与CKD患病率的校正优势比(AORs)。使用调查加权Cox比例风险模型计算CKD参与者全因死亡风险的LE8评分的调整风险比(AHRs)。结果:在纳入的8907名参与者中,789名为3至5期CKD, 8118名为非CKD组。低LE8评分组CKD校正患病率为10.7%,中LE8评分组为7.9%,高LE8评分组为7.7%。与低LE8评分相比,中等LE8评分(调整优势比[AOR] 0.628, 95%可信区间[CI]: 0.463 ~ 0.853, P = 0.004)和高LE8评分(调整优势比[AOR] 0.328, 95% CI: 0.142 ~ 0.759, P = 0.011)与低CKD患病率相关。健康因素得分也有类似的关联。此外,LE8评分的增加与全因死亡风险的降低相关(校正风险比[AHR] 0.702, 95% CI: 0.594 ~ 0.829, P < 0.001)。结论:本研究结果提示高LE8及其亚量表评分与较低的CKD患病率和全因死亡率相关。
{"title":"Association of life's essential 8 with prevalence and all-cause mortality of chronic kidney disease among US adults: Results from the National Health and Nutrition Examination Survey (2015-2018).","authors":"Wei Chen, Yuanjun Tang, Yachen Si, Boxiang Tu, Fuchuan Xiao, Xiaolu Bian, Ying Xu, Yingyi Qin","doi":"10.1515/jtim-2023-0119","DOIUrl":"10.1515/jtim-2023-0119","url":null,"abstract":"<p><strong>Background and objectives: </strong>The association between chronic kidney disease (CKD) and cardiovascular disease has been previously evaluated. This study aimed to evaluate the association between the American Heart Association's Life's Essential 8 (LE8) and the prevalence and all-cause mortality of CKD in a nationally representative population of adults in the US.</p><p><strong>Methods: </strong>This retrospective analysis included participants from the National Health and Nutrition Examination Survey spanning 2015-2018. We used multivariable survey logistic regression model to calculate the adjusted odds ratios (AORs) of the LE8 score for the prevalence of CKD. Survey-weighted Cox proportional hazards models were used to calculate the adjusted hazards ratios (AHRs) of the LE8 score for the risk of all-cause mortality among participants with CKD.</p><p><strong>Results: </strong>Of the 8907 included participants, 789 had stage 3 to 5 CKD, and 8118 were in the non-CKD group. The adjusted prevalence rate of CKD was 10.7% in the low LE8 score group, and lower in the moderate (7.9%) and high (7.7%) LE8 score groups. Compared with low LE8 scores, moderate LE8 score (adjusted odds ratio [AOR] 0.628, 95% confidence interval [CI]: 0.463 to 0.853, <i>P</i> = 0.004) and high LE8 scores (AOR 0.328, 95% CI: 0.142 to 0.759, <i>P</i> = 0.011) were associated with lower prevalence rates of CKD. A similar association was found for health factors scores. Additionally, an increase in the LE8 score was associated with a lower risk of all-cause mortality (adjusted hazard ratio [AHR] 0.702, 95% CI: 0.594 to 0.829, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The results of this study suggest the association of higher LE8 and its subscale scores with a lower prevalence and all-cause mortality of CKD.</p>","PeriodicalId":51339,"journal":{"name":"Journal of Translational Internal Medicine","volume":"12 6","pages":"581-591"},"PeriodicalIF":4.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and validation of web-based risk score predicting prognostic nomograms for elderly patients with primary colorectal lymphoma: A population-based study. 基于网络的风险评分预测老年原发性结直肠癌患者预后图的开发和验证:一项基于人群的研究。
IF 4.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-10 eCollection Date: 2024-12-01 DOI: 10.1515/jtim-2023-0133
Kui Wang, Lingying Zhao, Tianyi Che, Chunhua Zhou, Xianzheng Qin, Yu Hong, Weitong Gao, Ling Zhang, Yubei Gu, Duowu Zou
<p><strong>Background and objectives: </strong>Primary colorectal lymphoma (PCL) is an infrequently occurring form of cancer, with the elderly population exhibiting an increasing prevalence of the disease. Furthermore, advanced age is associated with a poorer prognosis. Accurate prognostication is essential for the treatment of individuals diagnosed with PCL. However, no reliable predictive survival model exists for elderly patients with PCL. Therefore, this study aimed to develop an individualized survival prediction model for elderly patients with PCL and stratify its risk to aid in the treatment and monitoring of patients.</p><p><strong>Methods: </strong>Patients aged 60 or older with PCL from 1975 to 2013 in the Surveillance, Epidemiology, and End Results database were selected and randomly divided into a training cohort (<i>n</i> = 1305) and a validation cohort (<i>n</i> = 588). The patients from 2014-2015 (<i>n</i> = 207) were used for external validation. The research team utilized both Cox regression and the least absolute shrinkage and selection operator (LASSO) regression to analyze potential predictors, in order to identify the most suitable model for constructing an OS-nomogram and an associated network version. The risk stratification is constructed on the basis of this model. The performance of the model was evaluated based on the consistency index (C-index), calibration curve, and decision curve analysis (DCA) to determine its resolving power and calibration capability.</p><p><strong>Results: </strong>Age, gender, marital status, Ann Arbor staging, primary site, surgery, histological type, and chemotherapy were independent predictors of Overall Survival (OS) and were therefore included in our nomogram. The Area Under the Curve (AUC) of the 1, 3, and 5-year OS in the training, validation, and external validation sets ranged from 0.732 to 0.829. The Receiver Operating Characteristic (ROC) curves showed that the nomogram model outperformed the Ann Arbor stage system when predicting elderly patients with PCL prognosis at 1, 3, and 5 years in the training set, validation dataset, and external validation cohort. The Concordance Index (C-index) also demonstrated that the nomogram had excellent predictive accuracy and robustness. The calibration curves demonstrated a strong agreement between observed and predicted values. In the external validation cohort, the C-index (0.769, 95%CI: 0.712-0.826) and calibration curves of 1000 bootstrap samples also indicated a high level of concordance between observed and predicted values. The nomogram-related DCA curves exhibited superior clinical utility when compared to Ann Arbor stage. Furthermore, an online prediction tool for overall survival has been developed: https://medkuiwang.shinyapps.io/DynNomapp/.</p><p><strong>Conclusion: </strong>This was the first study to construct and validate predictive survival nomograms for elderly patients with PCL, which is better than the Ann Arbor stage. It will
背景和目的:原发性结直肠癌(PCL)是一种罕见的癌症,在老年人群中发病率越来越高。此外,高龄与较差的预后相关。准确的预后对于诊断为PCL的个体的治疗至关重要。然而,对于老年PCL患者尚无可靠的预测生存模型。因此,本研究旨在建立老年PCL患者的个体化生存预测模型,并对其风险进行分层,以帮助患者的治疗和监测。方法:选择监测、流行病学和最终结果数据库中1975 - 2013年60岁及以上PCL患者,随机分为培训队列(n = 1305)和验证队列(n = 588)。选取2014-2015年的患者(n = 207)进行外部验证。研究小组利用Cox回归和最小绝对收缩和选择算子(LASSO)回归来分析潜在的预测因子,以确定构建OS-nomogram和相关网络版本的最合适模型。在此模型的基础上构建了风险分层。通过一致性指数(C-index)、校准曲线和决策曲线分析(DCA)对模型的性能进行评价,确定模型的分辨能力和校准能力。结果:年龄、性别、婚姻状况、安娜堡分期、原发部位、手术、组织学类型和化疗是总生存期(OS)的独立预测因子,因此被纳入我们的nomogram。在训练集、验证集和外部验证集中,1、3和5年OS的曲线下面积(AUC)范围为0.732至0.829。受试者工作特征(ROC)曲线显示,在训练集、验证数据集和外部验证队列中,nomogram模型在预测老年PCL患者1年、3年和5年预后方面优于Ann Arbor分期系统。一致性指数(C-index)也表明nomogram具有良好的预测准确性和稳健性。校正曲线显示,观测值与预测值之间有很强的一致性。在外部验证队列中,1000个bootstrap样本的c指数(0.769,95%CI: 0.712-0.826)和校准曲线也显示了观测值与预测值之间的高度一致性。与Ann Arbor期相比,nomogram相关DCA曲线表现出更好的临床应用价值。此外,还开发了一个在线预测总生存期的工具:https://medkuiwang.shinyapps.io/DynNomapp/.Conclusion:这是第一个构建和验证老年PCL患者预测生存图的研究,该研究优于Ann Arbor期。它将帮助临床医生更准确地管理老年PCL患者。
{"title":"Development and validation of web-based risk score predicting prognostic nomograms for elderly patients with primary colorectal lymphoma: A population-based study.","authors":"Kui Wang, Lingying Zhao, Tianyi Che, Chunhua Zhou, Xianzheng Qin, Yu Hong, Weitong Gao, Ling Zhang, Yubei Gu, Duowu Zou","doi":"10.1515/jtim-2023-0133","DOIUrl":"10.1515/jtim-2023-0133","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objectives: &lt;/strong&gt;Primary colorectal lymphoma (PCL) is an infrequently occurring form of cancer, with the elderly population exhibiting an increasing prevalence of the disease. Furthermore, advanced age is associated with a poorer prognosis. Accurate prognostication is essential for the treatment of individuals diagnosed with PCL. However, no reliable predictive survival model exists for elderly patients with PCL. Therefore, this study aimed to develop an individualized survival prediction model for elderly patients with PCL and stratify its risk to aid in the treatment and monitoring of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients aged 60 or older with PCL from 1975 to 2013 in the Surveillance, Epidemiology, and End Results database were selected and randomly divided into a training cohort (&lt;i&gt;n&lt;/i&gt; = 1305) and a validation cohort (&lt;i&gt;n&lt;/i&gt; = 588). The patients from 2014-2015 (&lt;i&gt;n&lt;/i&gt; = 207) were used for external validation. The research team utilized both Cox regression and the least absolute shrinkage and selection operator (LASSO) regression to analyze potential predictors, in order to identify the most suitable model for constructing an OS-nomogram and an associated network version. The risk stratification is constructed on the basis of this model. The performance of the model was evaluated based on the consistency index (C-index), calibration curve, and decision curve analysis (DCA) to determine its resolving power and calibration capability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Age, gender, marital status, Ann Arbor staging, primary site, surgery, histological type, and chemotherapy were independent predictors of Overall Survival (OS) and were therefore included in our nomogram. The Area Under the Curve (AUC) of the 1, 3, and 5-year OS in the training, validation, and external validation sets ranged from 0.732 to 0.829. The Receiver Operating Characteristic (ROC) curves showed that the nomogram model outperformed the Ann Arbor stage system when predicting elderly patients with PCL prognosis at 1, 3, and 5 years in the training set, validation dataset, and external validation cohort. The Concordance Index (C-index) also demonstrated that the nomogram had excellent predictive accuracy and robustness. The calibration curves demonstrated a strong agreement between observed and predicted values. In the external validation cohort, the C-index (0.769, 95%CI: 0.712-0.826) and calibration curves of 1000 bootstrap samples also indicated a high level of concordance between observed and predicted values. The nomogram-related DCA curves exhibited superior clinical utility when compared to Ann Arbor stage. Furthermore, an online prediction tool for overall survival has been developed: https://medkuiwang.shinyapps.io/DynNomapp/.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This was the first study to construct and validate predictive survival nomograms for elderly patients with PCL, which is better than the Ann Arbor stage. It will ","PeriodicalId":51339,"journal":{"name":"Journal of Translational Internal Medicine","volume":"12 6","pages":"569-580"},"PeriodicalIF":4.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Translational Internal Medicine
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