中国普通外科杂志2025，Vol.34Issue(7)：1401-1409,9.DOI:10.7659/j.issn.1005-6947.230402
化疗对原发性肝脏弥漫大B细胞淋巴瘤预后的影响:基于SEER数据库与机器学习的分析
Prognostic impact of chemotherapy in primary hepatic diffuse large B-cell lymphoma:a SEER-based machine learning analysis
摘要
Abstract
Background and Aims:Primary hepatic diffuse large B-cell lymphoma(DLBCL)is rare and carries a poor prognosis,with no large-scale evidence supporting the value of chemotherapy.This study used real-world,large-sample data from the SEER database to evaluate the prognostic impact of chemotherapy in patients with primary hepatic DLBCL. Methods:Clinical data of patients pathologically diagnosed with primary hepatic DLBCL between 2000 and 2019 were extracted from the SEER database and grouped according to whether they received chemotherapy.Kaplan-Meier survival analysis,Cox proportional hazards models,and random survival forest models were employed to identify factors influencing overall survival(OS)and cancer-specific survival(CSS),and subgroup analyses were performed. Results:A total of 594 patients were included,with a median age of 66 years;435(73.2%)received chemotherapy.After a median follow-up of 17.5 months,the median OS was 81(7-173)months in the chemotherapy group versus 11(2-171)months in the non-chemotherapy group.The OS and CSS rates in the chemotherapy group were significantly higher than those in the non-chemotherapy group(67.99%vs.47.77%;71.03%vs.52.87%,both P<0.05).Multivariate analysis showed that chemotherapy was an independent protective factor for OS(HR=0.39,95%CI=0.31-0.48)and CSS(HR=0.37,95%CI=0.29-0.48).In the random survival forest model,chemotherapy ranked highest in variable importance.Subgroup analyses produced consistent results. Conclusion:Chemotherapy is an independent prognostic factor for patients with primary hepatic DLBCL and can significantly improve survival.The R-CHOP regimen may be the preferred therapeutic option.关键词
肝肿瘤/淋巴瘤,大B细胞,弥漫性/药物疗法/预后/SEER规划Key words
Liver Neoplasms/Lymphoma,Large B-Cell,Diffuse/Drug Therapy/Prognosis/SEER Program分类
医药卫生引用本文复制引用
黄坤,王雯,杨婷,何运胜,冯俊..化疗对原发性肝脏弥漫大B细胞淋巴瘤预后的影响:基于SEER数据库与机器学习的分析[J].中国普通外科杂志,2025,34(7):1401-1409,9.基金项目
四川省绵阳市卫计委2023科研基金资助项目(202309) （202309）
四川省绵阳市中医药开发利用重点实验室2025开放基金资助项目(25ZYKF04) （25ZYKF04）
成都中医药大学2024校院联合创新基金资助项目(LH202402010). （LH202402010）
