本研究旨在探索预测甲状旁腺癌(PC)患者预后的可视化模型,并分析不同分期组的相关生化指标。
从监测中获得了342名PC患者的训练数据集,流行病学,和最终结果(SEER)数据库,验证数据集包括来自郑州大学第一附属医院的59例患者。进行单因素和多因素Cox回归分析以评估重要的独立预后因素。基于这些因素,构建列线图和基于Web的概率计算器,以评估3,5和8年时的总生存期(OS)和癌症特异性生存期(CSS).一致性指数(C指数),接收机工作特性(ROC)曲线,校正曲线,和决策曲线分析(DCA)用于评估训练集和验证集中的列线图。此外,通过Kruskal-Wallis检验对不同阶段组的验证组的生化指标进行回顾性分析.
年龄,婚姻状况,肿瘤大小,舞台,淋巴结状态,和辐射被确定为OS的预后因素。相比之下,只有肿瘤大小和分期可以预测CSS。列线图是根据这些独立因素制定的。C指数,ROC曲线,校正曲线,训练集和验证集的列线图和DCA表明,列线图具有良好的预测价值,稳定性,以及预测3-的临床益处,5-,以及PC患者的8年OS和CSS。在我院的59名PC患者中,在远处转移患者中发现较低的白蛋白(ALB)水平和较高的术后甲状旁腺激素(PTH)水平(远端与区域ALB水平:p=0.037;远处与局部ALB水平:p=0.046;远处与区域术后PTH水平:p=0.002;远处与术后局部PTH:p=0.002)。
建立的列线图应用程序可以为中国人群中的PC患者提供准确的预后,但它必须在前瞻性收集的真实世界数据上进行验证。
This
study aimed to explore a visual model for predicting the prognosis of patients with parathyroid carcinoma (PC) and analyze related biochemistries in different groups of stage.
The training dataset of 342 patients with PC was obtained from the Surveillance, Epidemiology, and End Results (SEER) database, and the validation dataset included 59 patients from The First Affiliated Hospital of Zhengzhou University. Univariate and multivariate Cox regression analyses were performed to evaluate significant independent prognostic factors. Based on those factors, nomograms and Web-based probability calculators were constructed to evaluate the overall survival (OS) and the cancer-specific survival (CSS) at 3, 5, and 8 years. The concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram in the training set and validation set. Moreover, biochemistries from the validation set were retrospectively analyzed in different groups of stage by Kruskal-Wallis test.
Age, marital status, tumor size, stage, lymph node status, and radiation were identified as prognostic factors of OS. In contrast, only tumor size and stage were predictive for CSS. The nomogram was developed based on these independent factors. The C-index, ROC curve, calibration curve, and DCA of the nomogram in both training and validation sets showed that the nomogram had good predictive value, stability, and clinical benefit in predicting 3-, 5-, and 8-year OS and CSS in PC patients. Among the 59 PC patients from our hospital, lower albumin (ALB) levels and higher postoperative parathyroid hormone (PTH) levels were found in patients with distant metastasis (Distant vs. Regional ALB levels: p = 0.037; Distant vs. Local ALB levels: p = 0.046; Distant vs. Regional postoperative PTH levels: p = 0.002; Distant vs. Local postoperative PTH: p = 0.002).
The established nomogram application can provide accurate prognostics for patients with PC in the Chinese population, but it must be validated on prospectively collected real-world data.