结合淋巴结比例为胃神经内分泌肿瘤术后患者建立预后模型。

IF 2.5 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Wen Liu, Hong-Yu Wu, Jia-Xi Lin, Shu-Ting Qu, Yi-Jie Gu, Jin-Zhou Zhu, Chun-Fang Xu
{"title":"结合淋巴结比例为胃神经内分泌肿瘤术后患者建立预后模型。","authors":"Wen Liu, Hong-Yu Wu, Jia-Xi Lin, Shu-Ting Qu, Yi-Jie Gu, Jin-Zhou Zhu, Chun-Fang Xu","doi":"10.4251/wjgo.v16.i8.3507","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lymph node ratio (LNR) was demonstrated to play a crucial role in the prognosis of many tumors. However, research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm (NEN) patients was limited.</p><p><strong>Aim: </strong>To explore the prognostic value of LNR in postoperative gastric NEN patients and to combine LNR to develop prognostic models.</p><p><strong>Methods: </strong>A total of 286 patients from the Surveillance, Epidemiology, and End Results database were divided into the training set and validation set at a ratio of 8:2. 92 patients from the First Affiliated Hospital of Soochow University in China were designated as a test set. Cox regression analysis was used to explore the relationship between LNR and disease-specific survival (DSS) of gastric NEN patients. Random survival forest (RSF) algorithm and Cox proportional hazards (CoxPH) analysis were applied to develop models to predict DSS respectively, and compared with the 8<sup>th</sup> edition American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging.</p><p><strong>Results: </strong>Multivariate analyses indicated that LNR was an independent prognostic factor for postoperative gastric NEN patients and a higher LNR was accompanied by a higher risk of death. The RSF model exhibited the best performance in predicting DSS, with the C-index in the test set being 0.769 [95% confidence interval (CI): 0.691-0.846] outperforming the CoxPH model (0.744, 95%CI: 0.665-0.822) and the 8<sup>th</sup> edition AJCC TNM staging (0.723, 95%CI: 0.613-0.833). The calibration curves and decision curve analysis (DCA) demonstrated the RSF model had good calibration and clinical benefits. Furthermore, the RSF model could perform risk stratification and individual prognosis prediction effectively.</p><p><strong>Conclusion: </strong>A higher LNR indicated a lower DSS in postoperative gastric NEN patients. The RSF model outperformed the CoxPH model and the 8<sup>th</sup> edition AJCC TNM staging in the test set, showing potential in clinical practice.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334026/pdf/","citationCount":"0","resultStr":"{\"title\":\"Combining lymph node ratio to develop prognostic models for postoperative gastric neuroendocrine neoplasm patients.\",\"authors\":\"Wen Liu, Hong-Yu Wu, Jia-Xi Lin, Shu-Ting Qu, Yi-Jie Gu, Jin-Zhou Zhu, Chun-Fang Xu\",\"doi\":\"10.4251/wjgo.v16.i8.3507\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lymph node ratio (LNR) was demonstrated to play a crucial role in the prognosis of many tumors. However, research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm (NEN) patients was limited.</p><p><strong>Aim: </strong>To explore the prognostic value of LNR in postoperative gastric NEN patients and to combine LNR to develop prognostic models.</p><p><strong>Methods: </strong>A total of 286 patients from the Surveillance, Epidemiology, and End Results database were divided into the training set and validation set at a ratio of 8:2. 92 patients from the First Affiliated Hospital of Soochow University in China were designated as a test set. Cox regression analysis was used to explore the relationship between LNR and disease-specific survival (DSS) of gastric NEN patients. Random survival forest (RSF) algorithm and Cox proportional hazards (CoxPH) analysis were applied to develop models to predict DSS respectively, and compared with the 8<sup>th</sup> edition American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging.</p><p><strong>Results: </strong>Multivariate analyses indicated that LNR was an independent prognostic factor for postoperative gastric NEN patients and a higher LNR was accompanied by a higher risk of death. The RSF model exhibited the best performance in predicting DSS, with the C-index in the test set being 0.769 [95% confidence interval (CI): 0.691-0.846] outperforming the CoxPH model (0.744, 95%CI: 0.665-0.822) and the 8<sup>th</sup> edition AJCC TNM staging (0.723, 95%CI: 0.613-0.833). The calibration curves and decision curve analysis (DCA) demonstrated the RSF model had good calibration and clinical benefits. Furthermore, the RSF model could perform risk stratification and individual prognosis prediction effectively.</p><p><strong>Conclusion: </strong>A higher LNR indicated a lower DSS in postoperative gastric NEN patients. The RSF model outperformed the CoxPH model and the 8<sup>th</sup> edition AJCC TNM staging in the test set, showing potential in clinical practice.</p>\",\"PeriodicalId\":23762,\"journal\":{\"name\":\"World Journal of Gastrointestinal Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334026/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4251/wjgo.v16.i8.3507\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4251/wjgo.v16.i8.3507","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:淋巴结比值(LNR)被证明在许多肿瘤的预后中起着至关重要的作用。目的:探讨淋巴结比在胃神经内分泌肿瘤(NEN)术后患者中的预后价值,并结合淋巴结比建立预后模型:方法:将监测、流行病学和最终结果数据库中的286名患者按8:2的比例分为训练集和验证集。中国苏州大学附属第一医院的 92 名患者被指定为测试集。采用 Cox 回归分析探讨了 LNR 与胃网状细胞癌患者疾病特异性生存率(DSS)之间的关系。随机生存森林(RSF)算法和Cox比例危险度(CoxPH)分析分别用于建立预测DSS的模型,并与第8版美国癌症联合委员会(AJCC)肿瘤-结节-转移(TNM)分期进行比较:多变量分析表明,LNR是胃NEN术后患者的独立预后因素,LNR越高,死亡风险越高。RSF模型在预测DSS方面表现最佳,测试集的C指数为0.769[95%置信区间(CI):0.691-0.846],优于CoxPH模型(0.744,95%CI:0.665-0.822)和第8版AJCC TNM分期(0.723,95%CI:0.613-0.833)。校准曲线和决策曲线分析(DCA)表明,RSF 模型具有良好的校准和临床效益。此外,RSF模型还能有效地进行风险分层和个体预后预测:结论:LNR越高,胃NEN术后患者的DSS越低。RSF模型在测试集中的表现优于CoxPH模型和第8版AJCC TNM分期,显示了其在临床实践中的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combining lymph node ratio to develop prognostic models for postoperative gastric neuroendocrine neoplasm patients.

Background: Lymph node ratio (LNR) was demonstrated to play a crucial role in the prognosis of many tumors. However, research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm (NEN) patients was limited.

Aim: To explore the prognostic value of LNR in postoperative gastric NEN patients and to combine LNR to develop prognostic models.

Methods: A total of 286 patients from the Surveillance, Epidemiology, and End Results database were divided into the training set and validation set at a ratio of 8:2. 92 patients from the First Affiliated Hospital of Soochow University in China were designated as a test set. Cox regression analysis was used to explore the relationship between LNR and disease-specific survival (DSS) of gastric NEN patients. Random survival forest (RSF) algorithm and Cox proportional hazards (CoxPH) analysis were applied to develop models to predict DSS respectively, and compared with the 8th edition American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging.

Results: Multivariate analyses indicated that LNR was an independent prognostic factor for postoperative gastric NEN patients and a higher LNR was accompanied by a higher risk of death. The RSF model exhibited the best performance in predicting DSS, with the C-index in the test set being 0.769 [95% confidence interval (CI): 0.691-0.846] outperforming the CoxPH model (0.744, 95%CI: 0.665-0.822) and the 8th edition AJCC TNM staging (0.723, 95%CI: 0.613-0.833). The calibration curves and decision curve analysis (DCA) demonstrated the RSF model had good calibration and clinical benefits. Furthermore, the RSF model could perform risk stratification and individual prognosis prediction effectively.

Conclusion: A higher LNR indicated a lower DSS in postoperative gastric NEN patients. The RSF model outperformed the CoxPH model and the 8th edition AJCC TNM staging in the test set, showing potential in clinical practice.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
World Journal of Gastrointestinal Oncology
World Journal of Gastrointestinal Oncology Medicine-Gastroenterology
CiteScore
4.20
自引率
3.30%
发文量
1082
期刊介绍: The World Journal of Gastrointestinal Oncology (WJGO) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of gastrointestinal oncology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信