实用肿瘤学杂志 ›› 2021, Vol. 35 ›› Issue (1): 35-40.doi: 10.11904/j.issn.1002-3070.2021.01.007

• 临床应用 • 上一篇    下一篇

甲状腺癌患者术后复发风险预测的列线图模型建立

徐志勇1,马晓良2   

  1. 1.沈阳医学院附属中心医院普外科(沈阳 110000);
    2.杭州市第一人民医院梅城分院(建德市第二人民医院)肿瘤科
  • 发布日期:2021-01-30
  • 通讯作者: 徐志勇,E-mail:306455538@qq.com
  • 作者简介:徐志勇,男,(1985-),硕士,主治医师,从事甲状腺肿瘤疾病,血管外科诊治的研究

Establishment of a nomogram model for predicting the risk of postoperative recurrence in patients with thyroid cancer

XU Zhiyong1,MA Xiaoliang2   

  1. 1.Department of General Surgery,The Affiliated Central Hospital of Shenyang Medical College,Shenyang 110000,China;
    2.Department of Oncology,Meicheng Branch of Hangzhou First People's Hospital(Jiande Second People's Hospital
  • Published:2021-01-30

摘要: 目的 建立预测甲状腺癌患者术后复发风险的列线图模型。方法 回顾性分析2015年7月—2017年12月因甲状腺癌于沈阳医学院附属中心医院普外科行手术治疗的患者临床资料,筛选甲状腺癌术后复发的独立危险因素,基于筛选结果建立列线图预测模型,并对模型的预测准确性进行内外部验证。结果 Logistic回归分析结果显示,肿瘤大小≥4 cm(OR=2.741,95% CI:1.259~5.966)、未分化癌(OR=4.974,95% CI:1.819~13.598)、腺体包膜浸润(OR=2.624,95% CI:1.093~6.300)、术前淋巴结转移(OR=2.628,95% CI:1.165~5.928)、Ⅲ期~Ⅳ期甲状腺癌(OR=2.984,95% CI:1.329~6.698)、单侧腺叶加峡部切除(OR=2.797,95% CI:1.1403~6.861)及未清扫淋巴结(OR=2.553,95% CI:1.269~5.134)是甲状腺癌术后复发的独立危险因素。基于以上独立危险因素建立列线图模型,模型验证显示,建模集和验证集的C-index分别为0.822和0.796;校正曲线均贴近于理想曲线,AUC分别为0.816(95% CI:0.788~0.856)和0.765(95% CI:0.731~0.802),说明该列线图模型具有良好的预测准确性。结论 甲状腺癌患者术后复发的危险因素较多,本文基于危险因素构建列线图模型具有良好的预测准确性,可为临床人员筛查高危人群和制定相关防治措施提供参考。

关键词: 甲状腺癌, 术后复发, 列线图, 风险模型

Abstract: Objective The aim of this study was to establish a nomogram model for predicting the risk of recurrence in patients with thyroid cancer.Methods The clinical data of patients who underwent surgery for thyroid cancer in our hospital from July 2015 to December 2017 were retrospectively analyzed,independent risk factors for postoperative recurrence of thyroid cancer were screened,and a nomogram prediction model was established based on the screening results.The prediction accuracy of the model was verified internally and externally.Results Logistic regression analysis showed that tumor size ≥ 4 cm(OR=2.741,95% CI:1.259~5.966),undifferentiated carcinoma(OR=4.974,95% CI:1.819~13.598),glandular infiltration(OR=2.624,95% CI:1.093~6.300),preoperative lymph node metastasis(OR=2.628,95% CI:1.165~5.928),stage Ⅲ~Ⅳ thyroid cancer(OR=2.984,95% CI:1.329~6.698),unilateral glandular lobe plus isthmus resection(OR=2.797,95% CI:1.1403~6.861),and undissected lymph nodes(OR=2.553,95% CI:1.269~5.134)were independent risk factors for recurrence of thyroid cancer after surgery.A nomogram model was established based on the above independent risk factors.The model verification showed that the C-index of the modeling set and the validation set were 0.822 and 0.796,respectively;the calibration curves were close to the ideal curve,and the AUC was 0.816(95% CI:0.788~0.856)and 0.765(95% CI:0.731~0.802),indicating that the nomogram model had a good predicted accuracy.Conclusion There are many risk factors for postoperative recurrence in patients with thyroid cancer.The nomogram model constructed based on the risk factors in this article has a good predictive accuracy,which can provide reference for clinical staff to screen high-risk groups and formulate relevant prevention and treatment measures.

Key words: Thyroid cancer, Postoperative recurrence, Nomogram, Risk model

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