中国实用外科杂志2025，Vol.45Issue(3)：322-328,339,8.DOI:10.19538/j.cjps.issn1005-2208.2025.03.16
肝内胆管癌术后生存预后预测列线图模型预后评估效能研究
Prognostic performance evaluation of a nomogram model for predicting postoperative survival in intrahepatic cholangiocarcinoma
摘要
Abstract
Objective To explore the independent risk factors after radical resection of intrahepatic cholangiocarcinoma(ICC)and construct a survival prognostic nomogram based on multicenter clinical data.Methods Data of 332 patients who underwent radical resection for ICC at Tianjin Medical University Cancer Institute & Hospital and Sichuan University West China Hospital between January 2011 and June 2018 were collected.Patients were divided into modeling and validation cohorts based on the institution,with 131 in the modeling cohort and 201 in the validation cohort.COX regression analysis was used to identify independent risk factors affecting the prognosis of ICC patients and to construct the nomogram.The predictive performance of the nomogram was evaluated using the concordance index,ROC curve,and calibration curve.Results Multivariate COX regression analysis indicated that CA19-9,tumor diameter,vascular invasion,differentiation,and TNM stage are independent risk factors influencing prognosis after radical resection for ICC(all P＜0.05).A nomogram was constructed based on these five factors,showing a C-index of 0.807 and AUC of 0.786 in the training cohort,and a C-index of 0.818 and AUC of 0.857 in the validation cohort.Conclusion The predictive model based on CA19-9,tumor diameter,vascular invasion,differentiation,and TNM stage demonstrates good prognostic prediction accuracy,providing a reference for individualized treatment in clinical practice.关键词
肝内胆管癌/生存预后/列线图/预测模型Key words
intrahepatic cholangiocarcinoma/survival prediction/nomogram/prediction model分类
临床医学引用本文复制引用
韩智强,尹毅青,王凯元,宋天强,黄纪伟,陈璐..肝内胆管癌术后生存预后预测列线图模型预后评估效能研究[J].中国实用外科杂志,2025,45(3):322-328,339,8.基金项目
国家自然科学基金面上项目(No.82373365,No.82173317) （No.82373365,No.82173317）
天津市教委科研计划项目(No.2021KJ197) （No.2021KJ197）
国际肝胆胰协会(IHPBA)Kenneth Warren Fellows项目(No.2023/2024) （IHPBA）
天津市医学重点学科(专科)建设项目(No.TJYXZDXK-009A) National Natural Science Foundation of China(General Program,No.82373365,No.82173317) （专科）
Tianjin Education Commission for Higher Education(No.2021KJ197) （No.2021KJ197）
2023/2023 IHPBA Kenneth Warren Fellowship(No.2023/2024) （No.2023/2024）
Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-009A) （No.TJYXZDXK-009A）
