摘要
Abstract
Objective To explore the influencing factors of fear of cancer recurrence(FCR)in adoles-cent patients with malignant bone tumors,and to establish and validate a prediction model for assessing the risk of FCR.Methods A total of 470 adolescent patients with malignant bone tumors treated at the hospital from May 2019 to December 2024 were enrolled.The patients were divided into a training set(329 cases)and a test set(141 cases)at a ratio of 7∶3.Patients in the training set were categorized into an FCR group and a non-FCR group based on the presence of FCR.Logistic regression analysis was used to identify independent risk factors and construct a prediction model to estimate the risk of FCR.The discrimination and calibration of the model were evaluated using receiver operating characteristic(ROC)curves and calibration curves.Decision curve analysis was employed to assess the clinical utility of the nomogram-based prediction model.Results Compared with the non-FCR group,the FCR group exhibited significantly higher age,higher proportions of stage Ⅲ-Ⅳdisease and disease duration>3 years,higher Family Hardiness Index(FHI)scores,and higher negative cop-ing style scores on the Simplified Coping Style Questionnaire(SCSQ),whereas positive coping style scores on the SCSQ and monthly per capita household income were lower,the differences were statistically significant(P<0.05).Internal validation[Hosmer-Lemeshow(H-L)goodness-of-fit test χ2=5.579,P=0.694,with the calibration curve closely fitting the ideal curve,and an area under the ROC curve(AUC)of 0.835(95%CI 0.771-0.899)],and external validation[H-L test χ2=14.037,P=0.081,a calibration curve closely coinci-ding with the ideal curve,and an AUC of 0.787(95%CI 0.714-0.861)]of the prediction model all demon-strated good goodness-of-fit,accuracy,and discrimination.Conclusion The prediction model constructed based on age,disease stage,monthly per capita household income,FHI score,and SCSQ scores(positive and negative coping styles)exhibits high accuracy and discrimination,and provides important guidance for individ-ualized prediction of the risk of FCR in adolescent patients with malignant bone tumors.关键词
恶性骨肿瘤/癌症复发恐惧/预测模型/危险因素Key words
Malignant bone tumor/Fear of cancer recurrence/Prediction model/Risk factors分类
医药卫生
