摘要
Abstract
Objective:To construct and validate a Nomogram model for predicting postoperative recurrence of tongue squamous cell carcinoma(TSCC)based on clinical characteristics and tumor markers.Methods:A total of 297 patients with TSCC who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were enrolled in this study.Clinical data were collected,and serum levels of vascular endothelial growth factor(VEGF),prolactin(PRL),and tissue polypeptide specific antigen(TPS)were measured.All patients were followed up until January 2024,and 288 completed follow-up.According to recurrence status,patients were divided into a recurrence group(n=71)and a non-recurrence group(n=217).Multivariate Cox regression analysis was performed to identify independent risk factors for postoperative recurrence.A Nomogram model was constructed using R software based on these factors,and its predictive performance and calibration were evaluated using receiver operating characteristic(ROC)and calibration curves.Results:The median follow-up time of the 288 patients was 48(41,53)months,and the postoperative recurrence rate was 24.65%(71/288).Multivariate Cox regression analysis showed that smoking history[hazard ratio(HR)=1.685,95%confidence interval(CI):1.164‒2.441],TNM stageⅢ(HR=1.848,95%CI:1.319‒2.589),infiltrative growth pattern(HR=1.935,95%CI:1.247‒3.001),undifferentiated and poorly differentiated status(HR=1.725,95%CI:1.163‒2.557),VEGF(HR=1.870,95%CI:1.345‒2.599),PRL(HR=1.664,95%CI:1.228‒2.254),and TPS(HR=1.480,95%CI:1.127‒1.943)were independent risk factors for postoperative recurrence(all P<0.01).The area under the ROC curve(AUC)of the nomogram model was 0.938(95%CI:0.904‒0.963),with a sensitivity of 87.32%and a specificity of 89.86%.The Hosmer-Lemeshow goodness-of-fit test indicated good model fit(P>0.05),and the calibration curve demonstrated good agreement between predicted and observed outcomes.The Nomogram model showed a significantly higher AUC than the 8th edition of American Joint Committee on Cancer(AJCC)TNM staging system(AUC=0.757,95%CI:0.703‒0.805,P<0.05).Conclusion:Smoking history,TNM stage Ⅲ,infiltrative growth pattern,undifferentiated/poorly differentiated status,and VEGF,PRL,and TPS are independent risk factors for postoperative recurrence of TSCC.The Nomogram model based on these clinical characteristics and tumor markers demonstrated good predictive performance and may provide a reference for individualized assessment of postoperative recurrence risk in patients with TSCC.关键词
舌鳞状细胞癌/复发/肿瘤标志物/列线图模型Key words
tongue squamous cell carcinoma/recurrence/tumor markers/Nomogram model分类
医药卫生
