Construction of a prognostic nomogram based on pathology for long-term survival after radical resection of intrahepatic cholangiocarcinoma
10.3760/cma.j.cn113884-20220320-00116
- VernacularTitle:肝内胆管癌患者根治性切除术后基于病理指标生存预测模型的构建与评估
- Author:
Yining ZOU
1
;
Kun ZHU
;
Xin ZHANG
;
Jing HAN
;
Lili ZHANG
;
Feng GAO
;
Xiaolei ZHANG
;
Yufeng HUANG
;
Akesu SUJIE
;
Yuan JI
Author Information
1. 上海交通大学医学院附属第九人民医院病理科，上海 200011
- Keywords:
Bile duct neoplasms;
Nomograms;
Pathology, clinical;
Overall survival
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(9):667-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish and evaluate a nomogram for long-term survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical resection.Methods:The data of ICC patients who underwent radical resection for the first time at Zhongshan Hospital, Fudan University from January 2014 to December 2017 were retrospectively analyzed. Of 167 patients who were enrolled, there were 104 males and 63 females, with the age of (60.3±10.9) years. Tumor tissues were collected for immunohistochemical staining and interpretation. Univariate Cox regression, LASSO regression and multivariate Cox regression were used to analyze influencing factors of postoperative long-term survival after ICC. R software was used to construct a nomogram in predicting ICC prognosis.Results:Cox regression analysis showed that TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression to be independent risk factors associated with poor long-term survival after radical resection. The prognostic nomogram model of ICC was constructed based on these factors. The C-index was 0.821. The nomogram model consistency index had a high degree of prognostic differentiation. The 45° diagonal of the 3-year postoperative calibration curve which represented the actual survival fitted well with the segmented line which represented the predicted survival of the nomogram. The area under the receiver operating characteristic curve of the nomogram model was higher than that of AJCC TNM staging (0.894 vs. 0.803, z=4.10, P<0.001). The nomogram model was more effective in predicting postoperative survival of ICC patients than the TNM staging. Conclusion:TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression were independent risk factors for postoperative survival of ICC. The nomogram model could better evaluate long-term prognosis of ICC patients after radical resection than the traditional TNM staging system.
