Models to predict outcome from childhood neuroblastoma: the role of serum ferritin and tumor histology.
Models to predict outcome from childhood neuroblastoma: the role of serum ferritin and tumor histology.
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DOI：
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发表时间：
1991-03
期刊：
影响因子：
11.2
通讯作者：
J. Silber;A. Evans;M. Fridman
中科院分区：
文献类型：
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作者：
J. Silber;A. Evans;M. Fridman
我们报告了三种多重逻辑回归模型的开发，用于预测未经骨髓移植治疗的患者死于儿童神经母细胞瘤的死亡。这些模型是使用 125 名患者的数据集开发的，这些患者的年龄、分期、血清铁蛋白和/或组织学可从诊断中获得。 77 名患者在诊断时记录了所有四个变量，其中 34 名患者记录了年龄、分期和血清铁蛋白，14 名患者记录了年龄、分期和组织学。所有患者从诊断起的最短时间为 3 年。四变量（完整）模型显示预测值阳性率（或 1 - 假阳性率）为 91.3%，预测值阴性率（或 1 - 假阴性率）为 94.4%。根据得出的“良好”和“不良”预后，为 77 名患者的完整模型以及使用不含铁蛋白或不含组织学的子集模型的相同患者构建了生存曲线。纠正诊断时注意到的预后因素，在研究期间无法确定时间趋势。所有三个模型中死亡概率的点估计均以图形形式显示。结果表明，诊断时的血清铁蛋白和肿瘤组织学具有独立的预后意义，并且可以通过四变量模型非常准确地预测神经母细胞瘤患者的预后。这些信息将有助于对患者进行骨髓移植和强化化疗方案分诊的良好和不良预后分类，并将有助于评估未来治疗创新的疗效。
We report on the development of three multiple logistic regression models to predict death from childhood neuroblastoma in patients treated without bone marrow transplantation. The models have been developed using a data set of 125 patients for whom age, stage, serum ferritin, and/or histology were available from diagnosis. Seventy-seven patients had all four variables recorded at diagnosis, 34 had age, stage, and serum ferritin, and 14 had age, stage, and histology. Minimum time from diagnosis for all patients was 3 years. The four-variable (full) model showed a predictive value positive rate (or 1 - the false positive rate) of 91.3% and a predictive value negative rate (or 1 - the false negative rate) of 94.4%. Survival curves, based on derived "good" and "poor" prognosis, were constructed for the full model of 77 patients and for the same patients using subset models either without ferritin or without histology. Correcting for prognostic factors noted at diagnosis, no time trend could be identified over the study period. Point estimates for the probability of death in all three models are displayed in graphical form. The results suggest that serum ferritin and tumor histology at diagnosis have independent prognostic significance and that patient outcome in neuroblastoma can be very accurately predicted with a four-variable model. Such information will help sort patients into good and poor prognosis for bone marrow transplant and intensive chemotherapy protocol triage and will help evaluate the efficacy of future therapeutic innovations.