ESCC术后患者5年生存预测模型的构建与验证
Construction and verification of 5-year survival prediction model for post-op ESCC patients.
摘要(中文译文)
为构建食管鳞状细胞癌（ESCC）患者术后5年生存率的预测模型，并为临床预后的准确评估提供依据。纳入2017年1月至2019年6月期间接受手术的260例ESCC患者，按7：3的比例随机分为训练集（n=182）和验证集（n=78）。在训练集中进行单因素和多因素Cox比例风险回归分析，以确定5年总生存期（OS）的独立预测因素。基于筛选出的因素构建列线图。采用一致性指数（C-index）、校准曲线、时间依赖性受试者工作特征（ROC）曲线和决策曲线分析（DCA）评估模型性能。训练集的5年OS率为63.7%（116/182）。多因素Cox回归确定了5个5年OS的独立预测因素：美国癌症联合委员会分期（HR=1.347，95% CI：1.209-1.510）、淋巴结转移（HR=4.698，95% CI：3.282-8.994）、肿瘤分化分级（HR=1.235，95% CI：1.105-1.276）、微血管密度（HR=1.089，95% CI：1.023-1.159）和血管内皮生长因子（VEGF）表达（HR=2.451，95% CI：1.127-6.372）。列线图显示出良好的区分能力，C-index值分别为0.886（训练集）和0.845（验证集）。ROC曲线下面积分别为0.889（95% CI：0.822-0.955）和0.844（95% CI：0.695-0.992）。校准曲线和DCA表明在较宽的阈值概率范围内具有令人满意的一致性和临床净获益。整合临床病理学和分子因素的列线图可有效预测ESCC患者术后5年OS，为个体化风险分层和临床决策提供可靠的视觉工具。
Abstract
To develop a predictive model for the 5-year postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC), and to provide a basis for the accurate assessment of clinical prognosis. A total of 260 ESCC patients who underwent surgery between January 2017 and June 2019 were included and randomly divided into a training set (n=182) and a validation set (n=78) at a 7:3 ratio. Univariate and multivariate Cox proportional hazards regression analyses were performed in the training set to identify independent predictors of 5-year overall survival (OS). A nomogram was constructed based on the selected factors. The model's performance was evaluated using the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). The 5-year OS rate in the training set was 63.7% (116/182). Multivariate Cox regression identified five independent predictors of 5-year OS: American Joint Committee on Cancer stage (HR = 1.347, 95% CI: 1.209-1.510), lymph node metastasis (HR = 4.698, 95% CI: 3.282-8.994), tumor differentiation grade (HR = 1.235, 95% CI: 1.105-1.276), microvessel density (HR = 1.089, 95% CI: 1.023-1.159), and Vascular Endothelial Growth Factor (VEGF) expression (HR = 2.451, 95% CI: 1.127-6.372). The nomogram demonstrated good discrimination, with C-index values of 0.886 (training set) and 0.845 (validation set). The areas under the ROC curves were 0.889 (95% CI: 0.822-0.955) and 0.844 (95% CI: 0.695-0.992), respectively. Calibration curves and DCA indicated satisfactory agreement and clinical net benefit across a wide threshold probability range. The nomogram integrating clinicopathological and molecular factors effectively predicts 5-year OS in ESCC patients after surgery, offering a reliable visual tool for individualized risk stratification and clinical decision-making.
如何引用
AMA
Zeyu Wang, Chaowei Li, Chao Ren, Shuyi Li, Shasha Yuan, Xu Yang, et al. Construction and verification of 5-year survival prediction model for post-op ESCC patients.. Frontiers in oncology. 2026; doi:10.3389/fonc.2026.1798175.
APA
Zeyu Wang, Chaowei Li, Chao Ren, Shuyi Li, Shasha Yuan, Xu Yang, et al (2026). Construction and verification of 5-year survival prediction model for post-op ESCC patients.. Frontiers in oncology. https://doi.org/10.3389/fonc.2026.1798175
GB/T 7714
Zeyu Wang, Chaowei Li, Chao Ren, Shuyi Li, Shasha Yuan, Xu Yang, et al. Construction and verification of 5-year survival prediction model for post-op ESCC patients.[J]. Frontiers in oncology, 2026 doi:10.3389/fonc.2026.1798175.
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