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投稿时间：2025-04-01 网络发布日期：2026-03-04
投稿时间：2025-04-01 网络发布日期：2026-03-04
中文摘要: 目的 探讨阳性淋巴结对数比（LODDS）对Ⅰ~Ⅱ期胃印戒细胞癌患者生存预后的预测价值，并构建基于LODDS 的列线图并进行验证。方法 回顾性收集 2013 年至 2017 年 680 例美国监测、流行病学和最终结果（SEER）数据库、62例江苏大学附属宜兴市人民医院Ⅰ~Ⅱ期胃印戒细胞癌患者的临床资料，分别作为试验集和验证集。应用X-tile 软件获取LODDS 的最佳截断值。应用Kaplan-Meier 法分析LODDS 的生存曲线，应用受试者工作特征（ROC）曲线分析 LODDS 对生存的预测作用，应用 Cox 回归分析Ⅰ~Ⅱ期胃印戒细胞癌患者预后的独立危险因素，并构建、验证基于 LODDS 的列线图。结果 LODDS在试验集中与患者性别、N分期相关（P<0.05），LODDS 在验证集中与 N 分期、化疗状态相关（P<0.05）；在试验、验证集中，低 LODDS 组患者的总生存率（OS）、癌症特异性生存率（CSS）最佳，中LODDS组患者次之，高LODDS组患者则最差（P<0.05）。T分期高、不接受化疗及高LODDS分别为Ⅰ~Ⅱ期胃印戒细胞癌患者的独立危险因素（P<0.05）。基于LODDS进一步构建列线图，其预测3年CSS的曲线下面积（AUC）在内部、外部验证中分别为0.765、0.809。此外，校正曲线也提示该列线图具有较好的预测效应。结论 高LODDS为Ⅰ~Ⅱ期胃印戒细胞癌患者的独立危险因素，基于LODDS的列线图具有较好的生存预测价值。
Abstract:Objective To explore the predictive value of log odds of positive lymph nodes（LODDS）for survival outcomes in stage Ⅰ-Ⅱ gastric signet ring cell carcinoma patients，thus constructing and verifying a LODDS-based nomogram. Methods Clinical data of 680 cases from the Surveillance, Epidemiology, and End results （SEER）Program and 62 patients with stage Ⅰ-Ⅱ gastric signet ring cell carcinoma from Yixing People’s Hospital Affiliated to Jiangsu University were retrospectively collected from 2013 to 2017 as the training set and validation set，respectively.The X-tile software was applied to identify best cut off values of LODDS. The Kaplan-Meier method was applied to plot survival curves according to LODDS categories，and the prognostic performance of LODDS was evaluated by receiver operating characteristic（ROC）curve analysis. The Cox regression analysis was used to identify independent risk factors for prognosis of stage Ⅰ-Ⅱ gastric signet ring cell carcinoma patients，which were further used to establish a LODDS-based nomogram. Results LODDS was associated with gender and N stage in training set（P<0.05），while LODDS was related with N stage and chemotherapy status in validation set（P<0.05）. According to overall survival（OS）and cancer specific survival（CSS）in both training and validation sets，low LODDS group had the best survival outcomes，followed by the medium LODDS group，while high LODDS group had the worst survival outcomes（P<0.05）. Additionally，high T stage，not receiving chemotherapy and high LODDS were independent risk factors for prognosis of stage Ⅰ-Ⅱ gastric signet ring cell carcinoma patients. The LODDS-based nomogram was further constructed, and the area under the curve（AUC）for predicting 3-year CSS was 0.765 and 0.809 in internal and external validation, respectively. Meanwhile，calibration curve showed the good predictive value of this nomogram. Conclusion High LODDS can be served as anindependent risk factor in stage Ⅰ-Ⅱ gastric signet ring cell carcinoma patients. The LODDS-based nomogram shows good predictive values for survival of these patients.
keywords: Gastric tumor Signet ring cell carcinoma Gastric cancer,stages Ⅰ-Ⅱ Log odds of positive lymph nodes Nomogram T stage Prognosis
文章编号： 中图分类号：R735.2 文献标志码：A
基金项目:南京医科大学无锡医学中心一般项目（WMCG202354）；南京医科大学附属无锡人民医院博士人才经费项目（BSRC202303）；国家卫生健康委员会医院管理所重大课题（YM2004ZD026）
附件
| Author Name | Affiliation |
| DU Yuan*，LIU Lei，WANG Cenzhu，DING Yucheng，FENG Shuhan，QIAN Ji | *Department of Pathology,Yixing People’s Hospital Affiliated to Jiangsu University,Wuxi,Jiangsu 214200,China |
引用文本：
杜媛,刘雷,王岑竹,等.基于阳性淋巴结对数比的Ⅰ~Ⅱ期胃印戒细胞癌预后列线图预测模型的构建及验证[J].中国临床研究,2026,39(2):199-204.
杜媛,刘雷,王岑竹,等.基于阳性淋巴结对数比的Ⅰ~Ⅱ期胃印戒细胞癌预后列线图预测模型的构建及验证[J].中国临床研究,2026,39(2):199-204.