|Table of Contents|

Construction and evaluation of nomogram prediction model for prognosis after radical gastrectomy based on preoperative PIV,NLR and CEA level

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 10
Page:
1869-1875
Research Field:
Publishing date:

Info

Title:
Construction and evaluation of nomogram prediction model for prognosis after radical gastrectomy based on preoperative PIV,NLR and CEA level
Author(s):
LU Tong1; FANG Yu1; LIU Haonan1; QU Pengfei2; HAN Zhengxiang3; WU Kejian4
1.The First Clinical Medical College of Xuzhou Medical University，Jiangsu Xuzhou 221002,China;2.Department of Gastroenterology,the Second Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221002,China;3.Department of Oncology;4.Department of Gastroenterology,Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221002,China.
Keywords:
gastric cancer; PIV; nomagram; prognosis model
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2023.10.018
Abstract:
Objective:Based on preoperative level of pan immune inflammation value (PIV),neutrophil-to-lymphocyte ratio (NLR) and carcinoembryonic antigen (CEA),to explore the influencing factors of prognosis after radical gastrectomy for gastric cancer,and to establish a nomogram prediction model.Methods:The clinical and pathological data of 384 patients with gastric cancer who underwent radical gastrectomy in the department of general surgery of Affiliated Hospital of Xuzhou Medical University from March 2016 to November 2019 were retrospectively analyzed.The best cutoff values of preoperative PIV,NLR and CEA level for predicting overall survival (OS) were analyzed by receiver operator characteristic (ROC) curve,and patients were divided into groups according to the best cutoff values of PIV.χ2 test was used to analyze the relationship between different PIV levels and clinicopathological features of gastric cancer patients.Kaplan-Meier method and Log-rank test were used to analyze the influence of different clinicopathological features on patients' OS,and multivariate Cox regression was used to analyze the independent influencing factors of patients' prognosis.R4.1.1 software was used to draw the nomogram prediction model of OS in patients with gastric cancer after radical gastrectomy for 1,3 and 5 years,and the effectiveness of the prediction model was evaluated.Then X-tile software was used to stratify the model according to the nomogram risk score to further explore the clinical application value of the model.Results:ROC curve analysis showed that the areas under PIV,NLR and CEA curves (AUC) were 0.627,0.584 and 0.590,respectively,and the best cut-off values were 236.8,1.98 and 4.93 ng/mL,respectively.PIV was related to age,tumor maximum diameter,tumor invasion depth,lymph node metastasis,TNM stage,nerve or vascular invasion and preoperative NLR level (P＜0.05).Multivariate Cox regression analysis showed that age,depth of tumor invasion,nerve or vascular invasion,PIV,NLR and CEA were independent influencing factors of 1,3,5 years OS in patients after radical gastrectomy (P＜0.05).A nomogram prediction model containing the above independent risk factors was constructed,and the internal verification consistency index (C index) of the model was 0.797,0.805 and 0.780,respectively.The calibration curve suggested that the model had good discrimination,and the OS of low-risk patients was significantly better than that of middle-risk and high-risk groups (P＜0.001).Conclusion:PIV,NLR,CEA has a good predictive value for the prognosis of gastric cancer,and the nomogram model based on PIV,NLR,CEA level and gastric cancer-related pathological data has a high guiding significance for clinic.

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Memo

Memo:
2020年江苏省高层次卫生人才“六个一工程”拔尖人才科研项目（编号：LGY2020006）
Last Update: 1900-01-01