| 转移淋巴结与鼻咽癌患者预后的相关分析 |
| 投稿时间：2025-08-01 修订日期：2025-09-16 点此下载全文 |
| 引用本文：刘昭,王将,邓斯佳,沈雨,王羽嫣,陈佳怡,许可,李连涛.转移淋巴结与鼻咽癌患者预后的相关分析[J].医学研究杂志,2026,55(1):57-63 |
| DOI：
10.11969/j.issn.1673-548X.2026.01.011 |
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| 基金项目:中国博士后自然科学基金面上项目(2022M722680)；江苏省自然科学基金面上项目(BK20231169)；江苏省高水平医院建设项目(LCZX202402) |
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| 中文摘要:目的 探讨转移性淋巴结密度与中晚期鼻咽癌(nasopharyngeal carcinoma,NPC)患者预后的相关性。建立并验证预测NPC患者无进展生存期(progression-free survival,PFS)的预后模型。方法 收集2008年1月~2019年5月于徐州医科大学附属医院接受系统性治疗的NPC患者。收集患者的临床资料及生存结果,并通过磁共振成像判读和记录转移淋巴结的空间特征。采用受试者工作特征曲线确定各定量资料的最佳临界值,并根据相应截断值将各定量资料转换为定性资料。通过COX分析以确定NPC预后的独立影响因素,并根据多变量分析结果生成诺模图(Nomogram)。采用C指数和校准曲线评价Nomogram模型的预测准确度和判别能力。结果 共纳入168例有颈部淋巴结转移的NPC患者(训练组134例,验证组34例)。COX单因素、多因素回归分析结果显示,单位距离淋巴结密度、体重指数、三维方向淋巴结最大径、有无淋巴结坏死、有无包膜外受侵是鼻咽癌患者PFS的独立危险因素(P＜0.05),并利用其开发和验证了预测中晚期NPC患者1、3、5年PFS的预后模型。决策曲线分析和C指数显示根据转移淋巴结空间特征构建的列线图具有较高的可靠性及临床应用价值。结论 本研究成功证明了NPC患者颈部转移淋巴结空间特征是重要的预后因素,利用其可预测中晚期NPC患者1、3、5年PFS。 |
| 中文关键词:鼻咽癌 淋巴结 预后 密度 |
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| Correlation Analysis of Metastatic Lymph Node and Prognosis of Patients with Nasopharyngeal Carcinoma. |
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| Abstract:Objective To investigate the correlation between metastatic lymph node density and prognosis in patients with advanced nasopharyngeal carcinoma (NPC). To establish and validate a prognostic model of progression-free survival (PFS) in patients with NPC. Methods Patients with NPC and received systematic treatment in the Affiliated Hospital of Xuzhou Medical University from January 2008 to May 2019 were collected. Clinical data and survival outcomes of the patients were collected, and the spatial characteristics of metastatic lymph nodes were interpreted and recorded by magnetic resonance imaging. The receiver operating characteristic curve was used to determine the optimal critical value for each quantitative data, and each quantitative data was converted to qualitative data according to the corresponding cut-off value. COX analysis was performed to determine the independent prognostic factors affecting the prognosis of NPC, and a nomogram was generated based on the results of multivariate analysis. C-index and calibration curves were used to evaluate the predictive accuracy and discriminative ability of the nomogram model. Results A total of 168NPC patients with cervical lymph node metastasis were included (134 in the training group and 34 in the validation group). COX univariate and multivariate regression analysis results showed that, lymph node density per distance, body mass index, maximum diameter of lymph nodes in three dimensions, presence of lymph node necrosis, presence of extraperitoneal invasion were independent risk factors for PFS in patients with nasopharyngeal carcinoma (P<0.05), and were used to develop and validate a prognostic model for predicting 1-, 3-, and 5-year PFS in patients with intermediate- and advanced-stage NPC. The DCA curves and C-index showed that the nomogram constructed based on the spatial characteristics of metastatic lymph nodes had high reliability and clinical application value. characteristics of the column line graphs constructed with excellent reliability and clinical application value. Conclusion This study successfully confirms that the spatial characteristics of cervical metastatic lymph nodes in NPC patients are important prognostic factors, which can predict 1-, 3-, and 5-year PFS in patients with intermediate- and advanced-stage NPC. |
| keywords:Nasopharyngeal carcinoma Lymph nodes Prognosis Density |
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