Cancer genetics

癌症遗传学
  • 文章类型: Journal Article
    MAGUKp55亚家族成员7,膜棕榈酰化蛋白亚家族的一部分,是促进上皮细胞极性的重要适配器,在多种癌症中具有越来越重要的意义,包括食道癌,肾透明细胞癌,乳腺癌,胰腺导管腺癌.本文旨在使用癌症基因组图谱和基因型-组织表达数据库确定MAGUKp55亚家族成员7在各种肿瘤类型中的作用。各种软件和网络平台,例如cBioPortal,GEPIA2,TIMER2,UALCAN,R,STRING,和大卫,用于获取和分析数据。值得注意的是,在大多数癌症中观察到MAGUKp55亚家族成员7的低表达。此外,MAGUKp55亚家族成员7的低表达预测癌症患者预后不良。突变是MAGUKp55亚家族成员7中最常见的遗传改变类型,在各种癌症中磷酸化位点被鉴定为S412和S490。此外,MAGUKp55亚家族成员7的表达与癌症相关的成纤维细胞和CD8+T细胞相关。基因富集分析表明MAGUKp55亚家族成员7通过Rap1信号通路影响癌症。本文阐明了MAGUKp55亚家族成员7在人类泛癌症预后和免疫反应中的生物学意义。
    MAGUK p55 subfamily member 7, a part of the membrane palmitoylated protein subfamily, is an essential adapter that promotes epithelial cell polarity and has increasing significance in multiple cancers, including esophageal cancer, clear cell renal cell carcinoma, breast cancer, and pancreatic ductal adenocarcinoma. This paper aims to determine the effect of the MAGUK p55 subfamily member 7 in various tumor types using The Cancer Genome Atlas and Genotype-Tissue Expression database. A variety of software and web platforms, such as cBioPortal, GEPIA2, TIMER2, UALCAN, R, STRING, and DAVID, were used to obtain and analyze data. Notably, low expression of MAGUK p55 subfamily member 7 was observed in most cancers. In addition, low expression of MAGUK p55 subfamily member 7 predicted poor prognoses in cancer patients. Mutation was the most frequent genetic alteration type in MAGUK p55 subfamily member 7, with the phosphorylation sites identified as S412 and S490 in various cancers. Furthermore, expression of MAGUK p55 subfamily member 7 was associated with cancer-related fibroblasts and CD8+ T cells. Gene enrichment analysis indicated that MAGUK p55 subfamily member 7 influences cancer through the Rap1 signaling pathway. This paper elucidates the biological significance of MAGUK p55 subfamily member 7 in human pan-cancer prognosis and immune response.
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  • 文章类型: Journal Article
    背景:观察性研究调查了恶性贫血(PA)与癌症之间的关系。然而,除了胃癌,结果大多是矛盾的。这项研究的目的是通过双向双样本孟德尔随机(MR)分析来研究PA与癌症之间的潜在因果关系。
    方法:欧洲样本FinnGen项目提供了PA和20种位点特异性癌症的遗传汇总数据。这种双向双样本MR设计主要使用逆方差加权(IVW)方法来评估PA与癌症风险之间的因果关系。进行Benjamini-Hochberg校正以减少由多次测试引起的偏差。
    结果:我们的研究表明PA与胃癌之间存在因果关系,前列腺癌,睾丸癌和皮肤恶性黑色素瘤,前列腺癌或胃癌与PA之间存在反向因果关系(P<0.05)。在Benjamini-Hochberg校正测试之后,PA与胃癌或前列腺癌之间仍然存在因果关系(P'<0.05),而PA与睾丸癌和皮肤恶性黑色素瘤之间仅有隐含的因果关系(P>0.05)。胃癌与PA之间仍存在反向因果关系(P<0.05)。而前列腺癌显示出隐含的反向因果关系(P>0.05)。此外,MR-Egger和MR-PRESSO测试未显示明显的水平多效性。
    结论:PA可能与睾丸癌遗传相关,前列腺癌,胃癌,皮肤恶性黑色素瘤.
    BACKGROUND: Observational study investigated the association between pernicious anemia (PA) and cancers. However, with the exception of gastric cancer, the results are mostly contradictory. The purpose of this study was to investigate the potential causal relationship between PA and cancers through bidirectional two-sample Mendelian randomized (MR) analysis.
    METHODS: The European sample FinnGen project provided the genetic summary data for PA and 20 site-specific cancers. This bidirectional two-sample MR design mainly used the inverse variance weighting (IVW) method to evaluate the causal relationship between PA and cancer risk. Benjamini-Hochberg correction was performed to reduce the bias caused by multiple tests.
    RESULTS: Our study shows that there was a causal relationship between PA and gastric cancer, prostate cancer, testicular cancer and malignant melanoma of skin, and there was a reverse causal relationship between prostate cancer or gastric cancer and PA (P < 0.05). After Benjamini-Hochberg correction test, there was still a causal correlation between PA and gastric or prostate cancer (P\' < 0.05), while there was only an implied causal association between PA and testicular cancer and malignant melanoma of skin (P\'> 0.05). There was still a reverse causal relationship between gastric cancer and PA (P\'< 0.05), while prostate cancer shows an implied reverse causal relationship(P\'> 0.05). In addition, MR-Egger and MR-PRESSO tests showed no significant horizontal pleiotropy.
    CONCLUSIONS: PA may be genetically associated with testicular cancer, prostate cancer, gastric cancer, and malignant melanoma of skin.
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  • 文章类型: Observational Study
    目的:使用列线图来预测死亡风险,并估计当前治疗对神经胶质瘤患者预后的影响。
    方法:根据选择标准,从监测流行病学和最终结果数据库中获得总共3798例病例。根据方差膨胀因子筛选的独立临床因素建立列线图,单变量分析和多变量Cox回归模型。然后,将总体人口分为高危人群,中风险和低风险组使用列线图得出的风险评分,研究治疗对不同亚组生存结果的影响。此外,基于赛后队列,通过log-rank检验评估治疗对生存结局的影响.
    结果:年龄,种族,疾病阶段,组织学类型,组织学分级,手术,放疗和化疗被确定为独立的预后因素。建立了具有良好辨别力和一致性的列线图。一般来说,接受手术的病人,放疗和化疗比那些没有获得更好的预后,低危队列中接受放疗的患者和高危队列中接受手术的患者除外.此外,异柠檬酸脱氢酶1/2(IDH1/2)野生型手术患者,放疗或化疗往往有更高的生存概率,而在IDH突变型队列中观察到一些不一致的结果。
    结论:手术,放疗和化疗改善了预后,而为低风险或高风险患者选择适当的局部治疗方法值得进一步考虑。IDH状态基因可能是治疗有效性的可靠指标。
    To use a nomogram to predict the risk of mortality and estimate the impact of current treatment on the prognosis of glioma patients.
    A total of 3798 cases were obtained from the Surveillance Epidemiology and End Results database according to the selection criteria. A nomogram was built on the independent clinical factors screened by the variance inflation factor, univariate analyses and a multivariate Cox regression model. Then, categorising the overall population into high-risk, medium-risk and low-risk groups using nomogram-derived risk scores, to study the impact of treatment on different subgroups\' survival outcomes. Furthermore, based on the postmatch cohorts, the influences of treatment on survival outcomes were assessed by the log-rank test.
    Age, race, stage of disease, histological type, histological grade, surgery, radiotherapy and chemotherapy were identified as the independent prognostic factors. A nomogram with good discrimination and consistency was built. Generally, the patients who underwent surgery, radiotherapy and chemotherapy were more likely to achieve better prognosis than those who did not, except for those who received radiotherapy in the low-risk cohort and those who underwent surgery in the high-risk cohort. Furthermore, the isocitrate dehydrogenase 1/2 (IDH1/2) wild-type patients with surgery, radiotherapy or chemotherapy tended to have higher survival probabilities, while some inconsistent results were observed in the IDH mutant-type cohort.
    Surgery, radiotherapy and chemotherapy improved the prognosis, while appropriate selection of topical treatment for the low-risk or high-risk patients deserves further consideration. IDH status gene might be a reliable indicator of therapeutic effectiveness.
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  • 文章类型: Journal Article
    三体核型发生在5%-10%的AML中。其突变景观和预后意义尚不明确。对156例三体性AML患者进行了分析,参考615例细胞遗传学正常(CN)AML患者。三体AML表现出不同的突变景观,更普遍的SMC1A,N/KRAS,ASXL1和BCOR,但CEBPAbZIP和NPM1突变≤60例,NPM1突变≤60例。NRAS突变与三体性AML的不良预后相关,而DNMT3A和FLT3-ITD突变具有中性效应.三体性AML在生物学上与CN-AML不同。
    Trisomy karyotype occurs in 5%-10% of AML. Its mutational landscape and prognostic significance are not well defined. A cohort of 156 trisomy AML patients was analysed, with reference to 615 cytogenetically normal (CN) AML patients. Trisomy AML showed distinct mutational landscape with more prevalent SMC1A, N/KRAS, ASXL1 and BCOR but fewer CEBPAbZIP and NPM1 mutations in patients ≤60, and fewer NPM1 mutations in those >60. NRAS mutations were associated with poor outcome in trisomy AML, whereas DNMT3A and FLT3-ITD mutations had neutral effect. Trisomy AML appeared biologically distinct from CN-AML.
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  • 文章类型: Journal Article
    背景:迄今为止,维生素D摄入与消化系统癌症发生的关系仍然引起研究者的争论。这项研究旨在调查维生素D摄入与消化系统癌症(食道癌,胃,肝,胰腺,和结直肠癌)通过双样本孟德尔随机化(MR)分析,使用从IEUOpenGWAS数据库派生的数据集。
    方法:本研究基于维生素D和消化系统癌症的全基因组关联研究(GWAS)。样本量范围从218,792到496,946个欧洲血统个体。该研究首先使用逆方差加权(IVW)调查了维生素D与每种消化系统癌症之间的因果关系,加权中位数,和MR-Egger回归,然后使用荟萃分析总结不同癌症的IVW结果。我们还进行了额外的敏感性测试,以评估结果的有效性。
    结果:在这项研究中,我们筛选出117个SNP作为25(OH)D的潜在工具变量,并确定101个固定SNP作为消化系统癌症的工具变量.IVW结果未能揭示遗传易感维生素D水平与消化系统癌症风险之间的任何因果关系(食管癌p=0.400,OR=1.397,95%CI0.642-3.040;胃癌p=0.796,OR=0.939,95%CI0.585-1.510;肝癌p=0.347,OR=1.445,95%CI0.671-3.109;胰腺癌p=0.6618,0.95OR=0.5127合并OR(比值比)为0.918(95%CI0.770-1.097,p=0.348)。
    结论:维生素D与消化系统癌症的发生之间没有因果关系。消化系统癌症的风险不能仅仅通过增加维生素D的摄入量来减轻。
    BACKGROUND: Hitherto, the association of vitamin D intake and digestive system cancers occurrence still causes disputation among the researchers. This study aimed to investigate the genetic relation between vitamin D ingestion and digestive system cancers (which are esophageal, gastric, hepatic, pancreatic, and colorectal cancers) by a two-sample Mendelian randomization (MR) analysis, using datasets derived from IEU OpenGWAS database.
    METHODS: This study is based on a genome-wide association study (GWAS) for vitamin D and digestive system cancers, with a sample amount ranging from 218,792 to 496,946 European ancestry individuals. The study first investigated the causal relationship between vitamin D and each digestive system cancers using inverse-variance weighting (IVW), weighted medians, and MR-Egger regression and then used meta-analysis to summarize the IVW results for the different cancers. We also performed additional sensitivity tests to assess the validity of the results.
    RESULTS: In this study, we screened out 117 SNPs as potential instrumental variables for 25(OH)D and identified 101 fixed SNPs as instrumental variables for digestive system cancers. The results of the IVW failed to reveal any causal relationship between the genetically predisposed vitamin D level and the risk of digestive system cancers (esophageal cancer p = 0.400, OR = 1.397, 95% CI 0.642-3.040; gastric cancer p = 0.796, OR = 0.939, 95% CI 0.585-1.510; hepatic cancer p = 0.347, OR = 1.445, 95% CI 0.671-3.109; pancreatic cancer p = 0.905, OR = 0.969, 95% CI 0.581-1.618; colorectal cancer p = 0.127, OR = 0.0.841, 95% CI 0.673-1.051). The pooled ORs (odds ratio) are 0.918 (95% CI 0.770-1.097, p = 0.348).
    CONCLUSIONS: There is no causal relationship between vitamin D and the occurrence of digestive system cancers. The risk of digestive system cancers cannot be alleviated by merely increasing vitamin D intake.
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  • 文章类型: Journal Article
    背景:中心体蛋白55(CEP55)在特定癌症中起重要作用。然而,在泛癌症中缺乏对CEP55的全面研究。
    方法:使用内部和多中心样本(n=15,823)分析了33种癌症的CEP55。通过Wilcoxon秩和检验和标准化平均差(SMD)评估肿瘤组和对照组之间的CEP55表达水平的差异。使用受试者工作特征(ROC)曲线评估CEP55在癌症中的临床价值,Cox回归分析,和Kaplan-Meier曲线。采用Spearman相关系数分析CEP55表达与免疫微环境的相关性。
    结果:成簇的规则间隔短回文重复序列的数据证实,CEP55对于多种癌症类型的癌细胞的存活至关重要。在20种癌症中观察到CEP55mRNA表达升高,包括多形性胶质母细胞瘤(p<0.05)。CEP55mRNA表达使得区分癌症标本和对照样本之间的21种癌症成为可能(AUC=0.97),表明CEP55预测癌症状态的潜力。CEP55的过表达与18种癌症类型的癌症个体的预后相关。显示其预后价值。CEP55表达与肿瘤突变负荷有关,微卫星不稳定,新抗原计数,和各种癌症的免疫微环境(p<0.05)。CEP55在癌症中的表达水平和临床相关性在肺鳞状细胞癌中使用内部和多中心样本进行验证(SMD=4.07;AUC>0.95;p<0.05)。
    结论:CEP55可能是多种癌症的免疫相关预测和预后标志物,包括肺鳞状细胞癌。
    BACKGROUND: Centrosomal protein 55 (CEP55) plays a significant role in specific cancers. However, comprehensive research on CEP55 is lacking in pan-cancer.
    METHODS: In-house and multi-center samples (n = 15,823) were used to analyze CEP55 in 33 cancers. The variance of CEP55 expression levels among tumor and control groups was evaluated by the Wilcoxon rank-sum test and standardized mean difference (SMD). The clinical value of CEP55 in cancers was assessed using receiver operating characteristic (ROC) curves, Cox regression analysis, and Kaplan-Meier curves. The correlations between CEP55 expression and the immune microenvironment were explored using Spearman\'s correlation coefficient.
    RESULTS: The data of clustered regularly interspaced short palindromic repeats confirmed that CEP55 was essential for the survival of cancer cells in multiple cancer types. Elevated CEP55 mRNA expression was observed in 20 cancers, including glioblastoma multiforme (p < 0.05). CEP55 mRNA expression made it feasible to distinguish 21 cancer types between cancer specimens and their control samples (AUC = 0.97), indicating the potential of CEP55 for predicting cancer status. Overexpression of CEP55 was correlated with the prognosis of cancer individuals for 18 cancer types, exhibiting its prognostic value. CEP55 expression was relevant to tumor mutation burden, microsatellite instability, neoantigen counts, and the immune microenvironment in various cancers (p < 0.05). The expression level and clinical relevance of CEP55 in cancers were verified in lung squamous cell carcinoma using in-house and multi-center samples (SMD = 4.07; AUC > 0.95; p < 0.05).
    CONCLUSIONS: CEP55 may be an immune-related predictive and prognostic marker for multiple cancers, including lung squamous cell carcinoma.
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  • 文章类型: Clinical Trial Protocol
    背景:胆囊癌(GBC)是一种侵袭性的消化系统癌症,预后不佳。鉴于缺乏有效的治疗选择,该疾病迅速复发,5年生存率<5%。我们的团队先前发现,相当比例的GBC组织含有ErbB相关通路的突变。阿法替尼是一种专门针对ErbB途径突变的化学合成药物。然而,其治疗GBC患者的疗效尚不清楚.循环肿瘤DNA(ctDNA)是指血液中由肿瘤的凋亡和坏死细胞原位释放的一部分无细胞DNA,转移灶或循环肿瘤细胞。基于ctDNA的液体活检是一种非侵入性的病理检测方法,为评估抗肿瘤药物的治疗效果提供了额外的价值。
    方法:我们对ErbB通路突变的GBC患者进行了一项关于阿法替尼联合吉西他滨和奥沙利铂(GEMOX)的多中心随机研究。参与后的3年随访期间,将进行涉及ErbB途径ctDNA检测的临床和生物学评估。该临床试验的主要目的是评估阿法替尼的临床疗效。无病生存期是主要终点,与阿法替尼治疗患者的血浆ctDNA相关。此外,我们将评估血浆ctDNA监测肿瘤复发和进展的敏感性和特异性。最后,我们将通过关注安全性指标来评估阿法替尼的安全性.
    背景:该研究得到了上海交通大学医学院附属新华医院和上海交通大学医学院附属仁济医院医学伦理审查委员会的批准。临床试验结果,甚至没有定论,将在同行评审的期刊上发表。
    背景:NCT04183712。
    Gallbladder cancer (GBC) is an aggressive type of digestive system cancer with a dismal outcome. Given the lack of effective treatment options, the disease rapidly reoccurs and 5-year survival rate is <5%. Our team previously found that a significant percentage of GBC tissues harboured mutations of the ErbB-related pathway. Afatinib is a chemically synthesised drug specifically targeting the ErbB pathway mutations. However, its efficacy in the treatment of patients with GBC remains unknown. Circulating tumour DNA (ctDNA) refers to a proportion of cell-free DNA in the blood which is released by apoptotic and necrotic cells from tumours in situ, metastatic foci or circulating tumour cells. ctDNA-based liquid biopsy is a non-invasive pathological detection method that offers additional value to evaluate the therapeutic efficacy of antitumour drugs.
    We conduct a multicentre and randomised study on afatinib combined with gemcitabine and oxaliplatin (GEMOX) in patients with ErbB pathway mutated GBC. Clinical and biological evaluation involving ErbB pathway ctDNA detection will be made during the 3-year follow-up after participation. The primary objective of this clinical trial is to evaluate the clinical efficacy of afatinib. Disease-free survival is the primary end point and will be correlated with plasma ctDNA of patients in the treatment with afatinib. In addition, we will evaluate the sensitivity and specificity of plasma ctDNA for monitoring tumour recurrence and progression. Finally, we will assess the safety of afatinib by keeping an eye on the safety indicators.
    The study was approved by the medical-ethical review committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The clinical trials results, even inconclusive, will be published in peer-reviewed journals.
    NCT04183712.
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  • 文章类型: Journal Article
    目的:胰腺导管腺癌(PDAC)是一种高致死性肿瘤,治疗选择有限。这里,我们鉴定了syndecan结合蛋白(SDCBP),也称为syntenin1,作为促进PDAC肿瘤进展的新型可靶向因子。我们还探索了抑制SDCBP表达的治疗策略。
    方法:我们使用了PDAC患者的样本,人类类器官模型,LSL-KrasG12D/+小鼠,LSL-Trp53R172H/+和Pdx1-Cre(KPC)鼠标型号,和PDX小鼠模型。免疫染色,集落形成试验,乙炔基-2-脱氧尿苷掺入测定,实时细胞分析,细胞凋亡试验,自动细胞追踪,invadopodia检测和明胶降解测定,共免疫沉淀,和下拉分析在这项研究中进行。
    结果:高SDCBP组的中位总生存期和无复发生存率明显短于低SDCBP组。体外和体内研究表明SDCBP促进PDAC增殖和转移。机械上,SDCBP抑制CK1δ/ε介导的YAP-S384/S387磷酸化,通过直接与YAP1相互作用进一步抑制β-TrCP介导的YAP1泛素化和蛋白酶体降解。SDCBP主要通过其PDZ1结构域与YAP1的TAD结构域相互作用。临床前KPC小鼠队列表明,吡啶硫酮锌(ZnPT)通过抑制SDCBP来抑制PDAC肿瘤进展。
    结论:SDCBP通过阻止YAP1β-TrCP介导的蛋白酶体降解促进PDAC的增殖和转移。因此,ZnPT可能是通过抑制SDCBP来抑制PDAC进展的有前途的治疗策略。
    Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal tumour with limited treatment options. Here, we identified syndecan binding protein (SDCBP), also known as syntenin1, as a novel targetable factor in promoting PDAC tumour progression. We also explored a therapeutic strategy for suppressing SDCBP expression.
    We used samples from patients with PDAC, human organoid models, LSL-KrasG12D/+mice, LSL-Trp53R172H/+ and Pdx1-Cre (KPC) mouse models, and PDX mouse models. Immunostaining, colony formation assay, ethynyl-2-deoxyuridine incorporation assay, real-time cell analysis, cell apoptosis assay, automated cell tracking, invadopodia detection and gelatin degradation assays, coimmunoprecipitation, and pull-down assays were performed in this study.
    The median overall survival and recurrence-free survival rates in the high-SDCBP group were significantly shorter than those in the low-SDCBP group. In vitro and in vivo studies have demonstrated that SDCBP promotes PDAC proliferation and metastasis. Mechanically, SDCBP inhibits CK1δ/ε-mediated YAP-S384/S387 phosphorylation, which further suppresses β-TrCP-mediated YAP1 ubiquitination and proteasome degradation by directly interacting with YAP1. SDCBP interacts with the TAD domain of YAP1, mainly through its PDZ1 domain. Preclinical KPC mouse cohorts demonstrated that zinc pyrithione (ZnPT) suppresses PDAC tumour progression by suppressing SDCBP.
    SDCBP promotes the proliferation and metastasis of PDAC by preventing YAP1 from β-TrCP-mediated proteasomal degradation. Therefore, ZnPT could be a promising therapeutic strategy to inhibit PDAC progression by suppressing SDCBP.
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  • 文章类型: Journal Article
    化疗广泛用于治疗癌症患者。然而,对化疗药物的耐药性仍然是临床关注的主要问题。肿瘤耐药的机制极其复杂,涉及基因组不稳定等因素,DNA修复,和染色体。最近出现的感兴趣的领域是染色体外环状DNA(eccDNA),由于基因组不稳定和染色体异常而形成。eccDNA广泛存在于生理健康个体中,但在肿瘤发生和/或治疗期间也作为耐药机制而出现。在这次审查中,本文就eccDNA在肿瘤耐药中的作用及其机制的研究进展作一综述。此外,我们讨论了eccDNA的临床应用,并提出了一些表征耐药生物标志物和开发潜在靶向癌症疗法的新策略。
    Chemotherapy is widely used to treat patients with cancer. However, resistance to chemotherapeutic drugs remains a major clinical concern. The mechanisms of cancer drug resistance are extremely complex and involve such factors such as genomic instability, DNA repair, and chromothripsis. A recently emerging area of interest is extrachromosomal circular DNA (eccDNA), which forms owing to genomic instability and chromothripsis. eccDNA exists widely in physiologically healthy individuals but also arises during tumorigenesis and/or treatment as a drug resistance mechanism. In this review, we summarize the recent progress in research regarding the role of eccDNA in the development of cancer drug resistance as well as the mechanisms thereof. Furthermore, we discuss the clinical applications of eccDNA and propose some novel strategies for characterizing drug-resistant biomarkers and developing potential targeted cancer therapies.
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  • 文章类型: Journal Article
    基于美国SEER数据库数据,评估老年原发性肝癌的危险因素并构建其预后的列线图模型。
    使用SEER*STAT软件从SEER数据库中提取原发性肝癌患者的最新数据,并包括所需的变量。对数据进行筛选,然后分为训练队列和验证队列。通过单变量和多变量Cox分析筛选变量来构建列线图模型。C指数,ROC和校准曲线用于模型评估。
    从2004年至2017年共提取了10824例合格病例,其中,7757例纳入训练队列,3247例纳入验证队列。模型的C指数为0.747(在训练队列中)和0.773(在验证队列中)。训练和验证队列的3年曲线下面积(AUC)分别为0.760和0.750,两个队列的5年AUC分别为0.761和0.748。校准曲线显示了所构建模型的理想校准。
    Cox回归分析后构建的列线图模型显示出适度的校准和判别特性,可在一定程度上为老年原发性肝癌的临床应用提供参考。
    To evaluate the risk factors and construct a nomogram model for the prognosis of primary liver cancer in the elderly based on the data from the US SEER database.
    The latest data of patients with primary liver cancer were extracted from the SEER database using SEER*STAT software, and the required variables were included. The data were screened and then divided into a training cohort and a validation cohort. A nomogram model was constructed by screening the variables through univariate and multivariate Cox analysis. The C-Index, ROC and calibration curves were used for model evaluation.
    A total of 10 824 eligible cases from 2004 to 2017 were extracted, among which, 7757 cases were included in the training cohort and 3247 in the validation cohort. The C-Index of the model was 0.747 (in the training cohort) and 0.773 (in the validation cohort). The 3-year area under the curve (AUCs) of the training and the validation cohorts were 0.760 and 0.750, and the 5-year AUCs of the two cohorts were 0.761 and 0.748. The calibration curves showed an ideal calibration of the constructed model.
    The nomogram model constructed followed by Cox regression analysis showed moderate calibration and discrimination property, and can provide reference to a certain extent for furture clinical application of primary liver cancer in the elderly.
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