老年分化型甲状腺癌患者的预后提名图模型:一项基于人群的研究。

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Medicine Pub Date : 2024-11-01 DOI:10.1097/MD.0000000000040381
Dasong Wang, Yan Yang, Hongwei Yang, Yu He, Zhengyan Wang, Maoshan Chen, Yunhui Huang, Lei Yang
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引用次数: 0

摘要

本研究旨在根据各种人口统计学和临床参数,开发并验证老年分化型甲状腺癌(DTC)患者的预后模型,以准确预测患者的预后。研究人员从 "监测、流行病学和最终结果 "数据库中筛选出2010年至2019年期间确诊为DTC且年龄超过55岁的患者。然后按7:3的比例将患者随机分为训练集和验证集,并将本中心的患者作为外部验证组。通过单变量和多变量考克斯比例危险回归分析确定独立的预后因素,然后利用这些因素绘制预测预后的提名图。使用一致性指数评估了提名图的鉴别能力,并使用校准图评估了校准情况。通过决策曲线分析确定了预测模型的临床实用性和优势。逐步 Cox 回归分析结果显示,年龄、婚姻状况、性别、多发性、T 期、N 期和 M 期等几个变量与老年 DTC 患者的总生存率显著相关。此外,年龄、肿瘤大小、多发性、T 分期、N 分期和 M 分期被确定为老年 DTC 患者癌症特异性生存的主要决定因素。利用这些预测因素,构建了估计总生存率和特定癌症生存率概率的提名图。如一致性指数所示,提名图显示了很高的预测准确性,校准图显示预测结果与实际结果一致。此外,决策曲线分析表明,提名图提供了大量临床净效益,表明其在临床实践中的实用性。
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Prognostic nomogram models for elderly patients with differentiated thyroid carcinoma: A population-based study.

This study aimed to develop and validate a prognostic model for elderly patients with differentiated thyroid carcinoma (DTC) based on various demographic and clinical parameters in order to accurately predict patient outcomes. Patients who were diagnosed with DTC and were over 55 years old between 2010 and 2019 were identified from the Surveillance, Epidemiology, and End Results database. The patients were then randomly divided into a training set and a validation set in a 7:3 ratio, and patients from our center were included as an external validation group. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic factors, which were then utilized to develop nomograms for predicting the prognosis. The discriminative ability of the nomograms was evaluated using the concordance index, and the calibration was assessed using calibration plots. The clinical usefulness and benefits of the predictive models were determined through decision curve analysis. The findings of the stepwise Cox regression analysis revealed that several variables, including age, marital status, sex, multifocality, T stage, N stage, and M stage, were significantly associated with overall survival in elderly patients with DTC. Additionally, age, tumor size, multifocality, T stage, N stage, and M stage were identified as the primary determinants of cancer specific survival in elderly patients with DTC. Using these predictors, nomograms were constructed to estimate the probability of overall survival and cancer specific survival. The nomograms demonstrated a high level of predictive accuracy, as evidenced by the concordance index, and the calibration plots indicated that the predicted outcomes were consistent with the actual outcomes. Furthermore, the decision curve analysis demonstrated that the nomograms provided substantial clinical net benefit, indicating their utility in clinical practice.

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来源期刊
Medicine
Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
4342
审稿时长
>12 weeks
期刊介绍: Medicine is now a fully open access journal, providing authors with a distinctive new service offering continuous publication of original research across a broad spectrum of medical scientific disciplines and sub-specialties. As an open access title, Medicine will continue to provide authors with an established, trusted platform for the publication of their work. To ensure the ongoing quality of Medicine’s content, the peer-review process will only accept content that is scientifically, technically and ethically sound, and in compliance with standard reporting guidelines.
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