摘要
Abstract
Objective To analyze the risk factors for the prognosis of elderly patients with lung squamous cell carcinoma and construct a prediction model based on SEER database.Methods Based on the SEER data-base,a total of 25 602 patients diagnosed with lung squamous cell carcinoma from 2004 to 2015 were selected as the research subjects.The patients were randomly divided into training set(17 921 cases)and validation set(7 681 cases)according to 7∶3.Kaplan-Meier survival curve was used to analyze the correlation between basic data and prognosis of patients with lung squamous cell carcinoma.Cox regression and LASSO regression anal-ysis were used to determine the independent risk factors for the prognosis of elderly patients with lung squa-mous cell carcinoma and a nomogram model was constructed.The predictive performance of the nomogram model was evaluated by C-index,receiver operating characteristic(ROC)curve and decision curve.Results Among the 25 602 patients,17 717(69.2%)died.Multivariate Cox regression analysis showed that older age,higher T stage,higher N stage,higher M stage and without surgery were risk factors for poor prognosis of elderly pa-tients with lung squamous cell carcinoma(P<0.05).The C-index used to evaluate the nomogram model in the training set and the validation set were 0.732(95%CI:0.727-0.736)and 0.733(95%CI:0.725-0.739)respectively.The area under the curve(AUC)of the training set model for predicting the prognosis of patients with lung squamous cell carcinoma at half a year,one year and three years was 0.772(95%CI:0.764-0.779),0.795(95%CI:0.789-0.802)and 0.846(95%CI:0.839-0.852)respectively.The area under the AUC of the validation set model for predicting the prognosis of patients with lung squamous cell carcinoma at half a year,one year,and three years was 0.774(95%CI:0.763-0.785),0.805(95%CI:0.795-0.815)and 0.839(95%CI:0.829-0.850)respectively.The decision analysis curve showed that the nomogram model had good clinical practicability.Conclusion The age,T stage,N stage,M stage and operation status have sig-nificant influence on the prognosis of elderly patients with lung squamous cell carcinoma.The constructed no-mogram model can intuitively and accurately predict the survival rate of patients,which can provide scientific basis for evaluation of the prognosis of elderly patients with lung squamous cell carcinoma.关键词
SEER数据库/列线图/肺鳞癌/生存预后/老年Key words
SEER database/nomogram/lung squamous cell carcinoma/survival prognosis/elderly分类
医药卫生
