背景:确定早发性结直肠癌(EOCRC)远处转移的危险因素对于阐明其病因和促进预防性治疗至关重要。本研究旨在表征EOCRC发病率的变异性,并辨别与同步肝脏相关的异质性和同质风险因素。肺,和肝肺转移。
方法:这项研究纳入了2010年至2015年SEER数据库中的EOCRC患者,并通过同步肝脏将患者分为三组,肺,和肝肺转移。每组具有不同转移类型的患者以7:3的比例随机分配到开发和验证队列。采用Logistic回归分析同步肝的异质性和同质性危险因素,肺,和肝肺转移患者的发展队列。建立列线图来计算转移的风险,并使用受试者工作特性(ROC)曲线和校准曲线对其性能进行定量评估。
结果:本研究共纳入16,336名符合EOCRC的患者,其中17.90%(2924/16,336)有远处转移。同步肝脏的总体发病率,肺,肝肺转移率为11.90%(1921/16,146),2.42%(390/16,126),和1.50%(241/16,108),分别。治疗前CEA值阳性,淋巴转移增加,肠壁浸润深度与三种远处转移类型呈正相关。相反,年龄的相关性,种族,原发肿瘤的位置,三种类型的组织学分级不一致。ROC曲线和校准曲线在预测EOCRC远处转移方面具有良好的性能。
结论:EOCRC远处转移的发生率存在显着差异,相关风险因素具有异质性和同质性。尽管本研究纳入了有限的风险因素,建立的列线图显示出良好的预测性能。
Identifying the risk factors for distant metastasis in early-onset colorectal cancer (EOCRC) is crucial for elucidating its etiology and facilitating preventive treatment. This study aims to characterize the variability in EOCRC incidence and discern both heterogeneous and homogeneous risk factors associated with synchronous liver, lung, and hepato-lung metastases.
This study included patients with EOCRC enrolled in the SEER database between 2010 and 2015 and divided patients into three groups by synchronous liver, lung, and hepato-lung metastases. Each group of patients with different metastasis types was randomly assigned to the development and validation cohort in a ratio of 7:3. Logistic regression was used to analyze the heterogeneous and homogenous risk factors for synchronous liver, lung, and hepato-lung metastases in the development cohort of patients. Nomograms were built to calculate the risk of metastasis, and the receiver operating characteristic (ROC) curve and calibration curve were used to quantitatively evaluate their performance.
A total of 16,336 eligible patients with EOCRC were included in this study, of which 17.90% (2924/16,336) had distant metastases. The overall incidences of synchronous liver, lung, and hepato-lung metastases were 11.90% (1921/16,146), 2.42% (390/16,126), and 1.50% (241/16,108), respectively. Positive CEA values before treatment, increased lymphatic metastases, and deeper invasion of intestinal wall were positively correlated with three distant types of metastases. On the contrary, the correlation of age, ethnicity, location of primary tumor, and histologic grade among the three types was inconsistent. The ROC curve and calibration curve proved to have fine performance in predicting distant metastases of EOCRC.
There are significant differences in the incidence of distant metastases in EOCRC, and related risk factors are heterogeneous and homogenous. Although limited risk factors were incorporated in this study, the established nomograms indicated good predictive performance.