临床神经外科杂志2025，Vol.22Issue(2)：193-200,8.DOI:10.3969/j.issn.1672-7770.2025.02.012
基于SEER数据库构建预测儿童髓母细胞瘤生存率的列线图及外部验证
Construction of a nomogram model for predicting survival rate of children with medulloblastoma based on the SEER database and its external validation
摘要
Abstract
Objective To construct a nomogram model for predicting the survival rate of childhood medulloblastoma(MB)based on the Surveillance,Epidemiology and End Results(SEER)database of the National Cancer Institute of the United States.Methods The data of 854 children(0-17 years old)with complete clinical information diagnosed in the SEER database from 2000 to 2021 were collected.Univariate and multivariate COX regression analysis were used to determine the independent factors affecting the prognosis of children with MB.The obtained prognostic independent factors were used to construct the nomogram model.The time-dependent receiver operating characteristic(ROC)curve,consistency index(C-index),prognostic calibration curve,and clinical decision curve analysis(DCA)were used to test the predictive ability of the model.A total of 32 children diagnosed with MB in Children's Hospital Affiliated to Zhengzhou University from 2017 to 2024 were collected as an external validation group,and the ROC curve and C-index were used again to test the predictive ability of the model.Results Among 854 children with MB selected from the SEER database,531 were male and 323 were female.Multivariate Cox regression analysis showed that independent prognostic factors included histopathological type,surgical method,radiotherapy,chemotherapy,and cerebrospinal fluid dissemination or metastasis(P＜0.05).The above prognostic factors were used to construct a nomogram model.The area under ROC curve(AUC)for predicting 3-year,5-year,and 10-year survival of MB children in the modeling group was 0.669,0.660,and 0.611,respectively,and the C-index was0.647(95％CI=0.629-0.666).The AUC for 1-year,3-year and 5-year survival rates in the external validation group were 0.905,0.836,and 0.754,respectively.The established nomogram model was verified by ROC curve,C-index,prognostic calibration curve and DCA curve,which proved that it had good predictive effect.Conclusions The histopathological type,surgical method,radiotherapy,chemotherapy and cerebrospinal fluid dissemination in children with MB are independent factors affecting the prognosis of children.The nomogram model constructed based on these independent factors has good predictive performance and clinical practicality.关键词
髓母细胞瘤/预测模型/SEER/儿童Key words
medulloblastoma/prediction model/SEER/children分类
临床医学引用本文复制引用
徐义强,禹金良,李泽林,郭华超,李涛,董留建,冯书彬,李大鹏..基于SEER数据库构建预测儿童髓母细胞瘤生存率的列线图及外部验证[J].临床神经外科杂志,2025,22(2):193-200,8.基金项目
2024年度河南省医学科技攻关计划项目(LHGJ20240559) （LHGJ20240559）
