尤文肉瘤预后相关因素及诺模图的构建

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摘要目的分析尤文肉瘤预后的相关因素，构建诺模图以个体化预测患者的远期生存率。方法收集SEER数据库2004—2015年登记的1 110例尤文肉瘤患者的临床资料，分析影响患者预后的危险因素，构建诺模图并进行内部验证，采用一致性指数(C-index)评估该预测模型的准确性。结果 1 110例尤文肉瘤(Ewing’s sarcoma，ES)患者3、5、10年累计生存率分别为70.46%(70.43%~70.49%)、61.70%(61.67%~61.73%)、54.41%(54.37%~54.45%)。多因素COX回归分析显示，年龄、人种、T分期、N分期、M分期、是否手术是影响尤文肉瘤患者预后的独立危险因素(P＜0.05)。根据6个独立危险因素构建诺模图预测模型，其3、5、10年生存率的校准曲线示诺模图预测模型与实际观察生存率之间具有较高的一致性(C-index=0.717，95%CI=0.708~0.726)。结论本文构建的ES患者3、5、10年预后诺模图评分系统的生存率预测效果较好，为临床提供了一种可供选择的可视生存率预测图。

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	于海泉 1
	田玉良 1
	路宁 2

关键词 ：尤文肉瘤, 预后相关因素, 诺模图

Abstract：Objective To analyze the related factors of Ewing's sarcoma prognosis，and to construct a nomogram to predict the long-term survival rate of patients.Methods The clinical data of 1 110 patients with primary tumors with Ewing's sarcoma registered in the SEER database from 2004 to 2015 were collected to analyze the risk factors affecting the prognosis of patients.The nomogram map was constructed and verified internally，and the accuracy of the prediction model was evaluated using the consistency index (C-index).Results The cumulative survival rates of 1 110 patients with ES in 3，5，and 10 years were 70.46% (70.43% to 70.49%)，61.70% (61.67% to 61.73%)，and 54.41% (54.37% to 54.45%)，respectively.Multivariate COX regression analysis showed that age，race，T stage，N stage，M stage，and whether surgery were independent risk factors for the prognosis of patients with Ewing sarcoma (P＜0.05).Then we construct a nomogram prediction model based on six independent risk factors.The calibration curves of 3，5，and 10 years survival rates showed a high consistency between the nomogram prediction model and the actual observed survival rate (C-index = 0.717，95% CI = 0.708 to 0.726).Conclusion The predictive effect of the nomogram scoring system for ES patients with 3，5，and 10 years is better，which provides an alternative visual survival prediction chart for the clinic.

Key words： Ewing's sarcoma prognostic related factors nomogram

作者简介: 于海泉(1976－ )，男，副主任医师，石家庄市第一医院骨三科，050011。

引用本文:

于海泉 1，田玉良 1，路宁 2. 尤文肉瘤预后相关因素及诺模图的构建[J]. 实用骨科杂志, 2019, 25(7): 602-606.
Yu Haiquan 1，Tian Yuliang 1，Lu Ning 2. Prognosis Related Factors of Ewing's Sarcoma and Construction of Nomogram. sygkzz, 2019, 25(7): 602-606.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2019/V25/I7/602

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