杜欢乐 张琳

    [摘要] 目的 使用Nomogram模型對头颈部鳞状细胞癌术后的远期生存情况进行预测及分析。 方法 资料来源于NationalCancer Institute SEER数据库，计算淋巴结转移度，并使用SPSS 21.0统计分析软件和R3.6.3软件进行所有数据统计以及生存分析的比较分析。X射线平铺软件用于确定淋巴结转移度的最佳截断值，并采用单因素比较分析影响Kaplan-Meier法和Log-rank法的预后的危险因素。研究分析具有显著Cox统计意义的危险因素，从而得到能够影响患者远期生存情况的独立因素。为了实现生存分析，使用了Kaplan Meier法。 结果 LNR与分化程度、TNM分期、T、N、M分期有明显的关系，与年龄、性别、手术方法不相关，LNR是一个独立的危险因素。根据年龄、T期、M期、LNR，建立脂质谱图，利用一致性指数(C-index)和校准图，得出预测模型具有更加准确的预测价值。 结论 LNR是头颈部鳞状细胞癌患者术后的可靠预测指标。手术方法不影响LNR的大小，所以不管是哪一种手术方式，LNR都可作为预测指标，也可作为影响头颈部鳞状细胞癌患者术后长期生存的独立危险因素。影响头颈部鳞状细胞癌术后远期生存情况的独立危险因素还包括年龄、T分期和M分期。

    [关键词] Nomogram模型;头颈部鳞状细胞癌;术后;远期生存情况

    [中图分类号] R735.2? ? ? ? ? [文献标识码] B? ? ? ? ? [文章编号] 1673-9701(2022)10-0050-05

    [Abstract] Objective To predict and analyze the long-term postoperative survival of head and neck squamous cell carcinoma using the Nomogram model. Methods The degree of lymph node metastasis was calculated from the National Cancer Institute SEER database.All data statistics and comparative analysis of survival analysis were performed using SPSS 21.0 statistical analysis software and R3.6.3 software. X-ray tiling software was used to determine the optimal cutoff value for lymph node metastasis.The prognostic factors were analyzed by the Kaplan-Meier method and log-rank method.The univariate comparison was used to analyze the risk factors affecting the prognosis. The risk factors with significant Cox statistical significance were studied and analyzed to obtain the independent factors that can affect the long-term survival of patients. The Kaplan Meier method was used to achieve survival analysis. Results LNR was significantly correlated with differentiation ......