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进展期胃癌SOX方案新辅助化疗疗效的列线图预测模型建立和分析
应俊1,游清2,张剑1*
0
(1. 海军军医大学(第二军医大学)长征医院肛肠外科, 上海 200003;
2. 海军军医大学(第二军医大学)长征医院胃肠外科, 上海 200003
*通信作者)
摘要:
目的 探讨进展期胃癌SOX方案新辅助化疗(NAT)的疗效及影响疗效的因素。方法 回顾性分析我院2010年2月至2016年4月收治的128例接受SOX方案NAT的进展期胃癌患者(NAT组)及128例行手术治疗未接受NAT的进展期胃癌患者(对照组)的临床资料。采用多因素Cox比例风险回归模型分析影响总生存期的因素,并基于相关变量建立预测NAT疗效的列线图预测模型。结果 NAT组患者中位生存时间为31个月,对照组为21个月,两组比较差异有统计学意义(P<0.05)。多因素Cox比例风险回归模型分析显示,年龄、肿瘤位置、肿瘤大小、癌胚抗原、CA 19-9、临床T分期、临床N分期、淋巴结转移及未接受SOX方案NAT是胃癌患者预后的独立危险因素(P均<0.05)。成功构建列线图预测模型,经内部验证该模型符合率良好,有较好的区分度和准确度,该预测模型与TNM分期相比具有较高的灵敏度和特异度。结论 SOX方案NAT能够改善进展期胃癌患者的状况,根据年龄、肿瘤大小、肿瘤部位、癌胚抗原、CA 19-9、临床T分期、临床N分期、是否有淋巴结转移和是否接受SOX方案NAT建立的列线图预测模型能够较好地预测进展期胃癌患者的预后。
关键词:  胃肿瘤  进展期胃癌  SOX方案  新辅助化学疗法  列线图
DOI:10.16781/j.0258-879x.2021.08.0833
投稿时间:2021-07-05修订日期:2021-08-07
基金项目:
Establishment and analysis of nomogram prediction model of SOX regimen neoadjuvant chemotherapy efficacy in advanced gastric cancer
YING Jun1,YOU Qing2,ZHANG Jian1*
(1. Department of Anorectal Surgery, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Department of Gastrointestinal Surgery, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China
*Corresponding author)
Abstract:
Objective To explore the efficacy of SOX regimen neoadjuvant chemotherapy (NAT) for advanced gastric cancer and its influencing factors. Methods The clinical data of 128 patients with advanced gastric cancer who received SOX regimen NAT (NAT group) and 128 patients with advanced gastric cancer who underwent surgical treatment without NAT (control group) in our hospital from Feb. 2010 to Apr. 2016 were analyzed retrospectively. A multivariate Cox proportional hazard regression model was used to analyze the factors affecting the overall survival, and a nomogram prediction model for predicting the efficacy of NAT was established based on related variables. Results The median survival time of patients in the NAT group was 31 months and that in the control group was 21 months. There was significant difference between the 2 groups (P<0.05). Multivariate Cox proportional hazard regression model analysis showed that age, tumor location, tumor size, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA 19-9), clinical T stage, clinical N stage, lymph node metastasis and not receiving SOX regimen NAT were the independent risk factors for the prognosis of gastric cancer patients (all P<0.05). The nomogram prediction model was successfully constructed. It had been verified internally that the model had a good coincidence rate, good discrimination and accuracy. By comparing the prediction model with the TNM staging, it was found that the nomogram prediction model had high sensitivity and specificity. Conclusion SOX regimen NAT can improve the condition of patients with advanced gastric cancer. According to age, tumor size, tumor site, carcinoembryonic antigen, CA 19-9, clinical T stage, clinical N stage, lymph node metastasis and whether or not to receive SOX regimen NAT, the prediction model established by the nomogram can better predict the prognosis of advanced gastric cancer patients.
Key words:  stomach neoplasms  advanced gastric cancer  SOX regimen  neoadjuvant chemotherapy  nomogram