用 Nomogram 分析口咽癌的预后

摘要

Objective:Improving the AJCC orpharyngeal cancer prognosis scoring system and drawing Nomogram for its visual to make the oropharyngeal cancer prognostic -scoring system more accurate and effective.Methods:In-crease commonly used clinical indicators on AJCC seventh edition scoring system and use Cox regression model to construct the scoring system.Moreover,the scoring system can be more visual and effective using the Nomogram.Re-sults:Using Cox regression filter out gender,age,location of tumor,treatment are independent risk factors affecting prognosis.Compared with the AJCC seventh edition,the new scoring system has a higher prediction accuracy of surviv-al(C -index 0.730 4 vs 0.702 8,P <0.05).Conclusion:This study established a new oropharyngeal cancer scoring system for prediction of 5 years and 10 years survival and the new scoring system has a good forecast effect.Nomogram provides a personalized graph for visual of the survival prediction.%目的：改进美国肿瘤学会（American Joint Committee on Cancer，AJCC）口咽癌预后评分系统并绘制其可视化的 Nomogram，从而使口咽癌预后评分更加精准高效。方法：在 AJCC 第七版评分系统的基础上增加常用临床指标，采用 Cox 回归建立模型，并进一步用 Nomogram 可视化该评分系统，使其更加直观快捷。结果：与 AJCC 第七版相比，添加性别、年龄、肿瘤位置、治疗方式四个变量后的新评分系统具有更高的预测精度（一致性指数 C －index 0．7304 vs 0．7028，P ＜0．05），新系统的 Nomogram 可以个性化的预测每个患者的生存率。结论：建立了一个新的口咽癌5年和10年预后评分系统，新的评分系统具有很好的预测效果。Nomogram 提供了一个个性化的可视生存概率预测图。