老年浅表食管鳞癌淋巴结转移的预测研究

doi:10.3969/j.issn.1003-9198.2026.02.013

摘要/Abstract

摘要： 目的基于老年浅表食管鳞癌患者的临床病理特征和病理结果,建立浅表食管鳞癌的淋巴结转移风险预测模型。方法收集江苏省人民医院院接受食管切除术的539例年龄＞65岁食管鳞癌患者的临床资料,将2010年1月至2014年9月期间接受手术的366例患者纳入建模组,2014年12月至2016年9月接受手术的173例患者纳入验证组。采用多因素logistic回归分析明确建模组中与淋巴结转移相关的独立风险因素。绘制列线图,建立淋巴结转移风险预测模型,并在验证组中进行验证。结果建模组中有53例发生淋巴结转移,验证组中有30例发生淋巴结转移。多因素logistic回归分析结果表明,与淋巴结转移相关的危险因素包括肿瘤体积大、肿瘤分化程度低、浸润程度深和已发生淋巴血管的侵犯。预测模型在建模组和验证组中预测淋巴结转移时展现出良好的判别能力,AUC为0.80(95%CI:0.74~0.86)和0.81(95%CI:0.72~0.90)。校准曲线拟合良好,表明模型的预测能力准确可靠。结论本研究建立的预测模型可以用于预测老年浅表食管鳞癌患者的淋巴结转移风险。

关键词: 浅表型食管鳞癌, 淋巴结转移, 风险预测模型, 老年人

Abstract: Objective To develop and validate a predictive model for lymph node metastasis (LNM) risk in elderly patients with superficial esophageal squamous cell carcinoma (SESC) using clinicopathological variables. Methods The clinical data of 539 SESC patients aged >65 years undergoing curative esophagectomy in Jiangsu Province Hospital were retrospectively analyzed. The patients from January 2010 to September 2014 were enrolled in training group(n=366), and the patients from December 2014 to September 2016 were enrolled in validation group(n=173). Multivariate logistic regression analysis were used to identify the independent risk factors for LNM in training group.A nomogram model was established for predicting LNM risk and validated in validation group. Results In training group,53 patients presented with LNM, compared with 30 cases in validation group. The independent risk factors for LNM included larger tumor size,poor tumor differentiation,deeper invasion depth,presence of angiolymphatic invasion.The model got a good performance with the area of the curve of 0.80 (95%CI: 0.74-0.86) in training cohort,and 0.81 (95%CI: 0.72-0.90) in validation cohort. Conclusions This validated four-variable nomogram provides a clinically applicable tool for quantifying LNM risk in elderly SESC patients.

Key words: lymph node metastasis, superficial esophageal squamous cell carcinoma, risk predictive model, aged

中图分类号:

R 735.1

曹曜麟, 黄玉明, 杨金鹏, 王伟, 周悦, 李孟兰. 老年浅表食管鳞癌淋巴结转移的预测研究[J]. 实用老年医学, 2026, 40(2): 169-173.

CAO Yaolin, HUANG Yuming, YANG Jinpeng, WANG Wei, ZHOU Yue, LI Menglan. Predictive study of lymph node metastasis in elderly patients with superficial esophageal squamous cell carcinoma[J]. Practical Geriatrics, 2026, 40(2): 169-173.

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