口腔颌面外科杂志2025，Vol.35Issue(5)：382-390,9.DOI:10.12439/kqhm.1005-4979.2025.05.007
基于SEER数据库构建牙龈癌患者生存率的列线图预测模型及其效果评价
Development and validation of a nomogram prediction model for survival rates in gingival carcinoma based on the SEER database
摘要
Abstract
Objective:To develop and validate a nomogram prediction model based on gingival carcinoma patient data from the Surveillance,Epidemiology,and End Results(SEER)database of the National Cancer Institute in the United States,and evaluate its effectiveness.Methods:The basic information,clinical information,and follow-up data of patients diagnosed with gingival carcinoma between 2004 and 2018 was downloaded from the SEER database,and the patients were randomly divided into a modeling group(70%)and a validation group(30%).Through univariate and multivariate Cox regression analysis,variables were screened to determine independent prognostic risk factors for gingival carcinoma patients,and a nomogram was constructed.The prediction model was evaluated from three perspectives:Discrimination,calibration,and clinical applicability.X-Tile software was used for risk stratification of the gingival carcinoma patients.Results:This study included 3 334 patients with gingival carcinoma,with 3-year,5-year,and 10-year survival rates of 59.03%,48.89%,and 30.09%,respectively.The concordance index(C-index)of the modeling group and validation group was 0.716 and 0.715,respectively;the receiver operating characteristic(ROC)curve results showed that the area under the curve(AUC)for predicting the 3-year,5-year,and 10-year overall survival rates of gingival carcinoma patients in the modeling group was 0.758,0.759,and 0.769,respectively.In the validation group,they were 0.746,0.764,and 0.788,respectively.The C-index and AUC of the nomogram were higher than those of the traditional TNM staging system(P<0.001).The calibration curve results indicate that the nomogram model has good predictive accuracy.The decision curve analysis(DCA)results show that the nomogram has good clinical application value and is superior to the traditional TNM staging system.Patients were divided into low-risk group(<118.4 points),medium-risk group(118.4-213.6 points),and high-risk group(>213.6 points)based on the cutoff value of the total score in the nomogram.There was a statistically significant difference in survival rate among the three groups(P<0.001).Conclusion:Age,marital status,histological grading,T stage,N stage,surgical status,and radiotherapy status are factors affecting the survival of patients with gingival carcinoma.The nomogram prediction model constructed in this study can provide reference for predicting the prognosis of gingival carcinoma patients.关键词
牙龈癌/危险因素/列线图/SEER数据库/预后/预测模型Key words
gingival carcinoma/risk factors/nomogram/SEER database/prognosis/prediction model分类
口腔医学引用本文复制引用
艾山·依力哈木,克热木·阿巴司,魏奕茹,徐隽..基于SEER数据库构建牙龈癌患者生存率的列线图预测模型及其效果评价[J].口腔颌面外科杂志,2025,35(5):382-390,9.基金项目
新疆维吾尔自治区自然科学基金(2021D01C321) （2021D01C321）
