临床小儿外科杂志2025，Vol.24Issue(3)：243-249,7.DOI:10.3760/cma.j.cn101785-202207009-008
神经母细胞瘤患儿生存预测模型的构建和验证
Establishment and validation of a survival prediction model for children with neuroblastoma
摘要
Abstract
Objective To establish and validate a clinical prediction model assessing the survival of chil-dren with neuroblastoma(NB).Methods The relevant clinical data were collected from NB children between 2000 and 2019 from the database of Surveillance,Epidemiology and End Results(SEER).The primary cohort was randomized into two sets of training(n=987)and validation(n=493).The prognostic effects of variables were examined with a Cox proportional hazard model.Nomograms were established for estimating 1/3/5-year overall survival(OS)based upon Cox regression model.Concordance index(C-index),area under time-dependent re-ceiver operating characteristics curve(AUC-ROC),calibration plotting and decision-curve analysis(DCA)were utilized for evaluating the model.Results The results of the multivariate Cox regression analysis indicated that 1-5 years(HR=3.595,95％CI:2.122-6.091)or ≥5 years(HR=4.556,95％CI:2.566-8.091),tumour length ≥ 7.5 cm(HR=1.934,95％CI:1.347-2.777),tumour located in the adrenal and retroperito-neal(HR=1.520,95％CI:1.029-2.247),tumour metastasis(HR=5.263,95％CI:2.146-12.907),and not receiving surgical treatment(HR=1.866,95％CI:1.225-2.833)were identified as independent risk fac-tors for poor prognosis in children with neuroblastoma.A nomogram was constructed based on the aforemen-tioned independent prognostic factors for the purpose of overall survival prediction at 1/3/5-year in children with neuroblastoma.C-index of prediction model in training and validation sets were 0.803 and 0.785 respec-tively.AUC of ROC curves in training set at 1/3/5-year overall survival were 0.782,0.829 and 0.842 respec-tively.Validation set revealed that AUC of ROC curve of 1/3/5-year overall survival were 0.748,0.807 and 0.855 respectively.DCA indicated that using the nomogram for predicting the prognosis of NB children was more beneficial at a prediction probability threshold of(0.1-0.6).Conclusions Nomogram is a reliable and powerful tool for distinguishing and predicting the survival of NB children,thus assisting clinicians in mak-ing clinical decisions.关键词
神经母细胞瘤/列线图/预后/外科手术/儿童Key words
Neuroblastoma/Nomogram/Prognosis/Surgical Procedures,Operative/Child引用本文复制引用
陈伟明,白建喜,张炳,吴典明,方一凡..神经母细胞瘤患儿生存预测模型的构建和验证[J].临床小儿外科杂志,2025,24(3):243-249,7.基金项目
福建省自然科学基金(2023J011300) （2023J011300）
福建医科大学启航基金(2021QH1168) Natural Science Foundation of Fujian Province(2023J011300) （2021QH1168）
Startup Grant for Scien-tific Research,Fujian Medical University(2021QH1168) （2021QH1168）
