基于SEER数据库的小肠腺癌患者预后的危险因素分析及预测模型构建OACSTPCD

Objective To explore the risk factors affecting the prognosis of patients with small bowel adenocarcinoma(SBA),construct the SBA survival risk model,and evaluate the clinical predictive value.Methods Clinical information and prognosis data of 2 639 patients included in the surveillance,epidemiology,and end results(SEER)database were retrospectively analyzed.Overall survival(OS)and disease specific survival(DSS)were used as prognostic indicators.The training group and validation group were randomized at a 7 ∶ 3 ratio using univariate and multivariate Cox regression analysis.Prognostic factors affecting SBA sur-vival were screened,and a prognostic prediction model was constructed.The receiver operation characteristic curve,model valida-tion by validation group,and clinical decision curve.Results Age(P<0.01),tumor site(P = 0.018),size(P = 0.042),T stage(P<0.01),detection rate of positive lymph nodes(P<0.01),single tumor focus(P<0.01),and secondary liver metastasis(P<0.01)were independent risk factors affecting prognosis of OS in patients with SBA;age(P<0.01),tumor size(P= 0.022),T stage(P<0.01),detec-tion rate of positive lymph nodes(P<0.01),single tumor focus(P<0.01),and secondary liver metastasis(P<0.01)were independent risk factors affecting the prognosis of DSS in patients with SBA.The nomogram,survival risk assessment model,and calibration prediction curve were consistent with the actual curve.Conclusion Age,tumor size,T stage,detection rate of positive lymph nodes,single tumor focus,and secondary liver metastasis were independent risk factors for OS and DSS in patients with SBA.Tumor site was also an inde-pendent risk factor for OS in SBA patients.The established prognostic prediction model has good predictive value,can effectively evaluate the prognosis of SBA patients,and can provide reasonable treatment advice for patients.