Prognostic-Related Metabolic Score for Survival Prediction in Early-Stage Endometrioid Endometrial Cancer: A Multi-Center and Retrospective Study.
Prognostic-Related Metabolic Score for Survival Prediction in Early-Stage Endometrioid Endometrial Cancer: A Multi-Center and Retrospective Study.
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早期子宫内膜类子宫内膜癌的生存预测的预后相关代谢评分：一项多中心和回顾性研究。
DOI：
10.3389/fmed.2022.830673
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发表时间：
2022
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
子宫内膜癌（EC）合并代谢综合征（MetS）患者的预后比未合并MetS的患者更差。本研究旨在探讨部分代谢紊乱是否显著影响早期类神经胶质瘤样癌（EEC）的生存，并寻找一种更有效的方法来评估代谢状态。这是一项全国性的多中心队列研究，纳入了2001年至2018年的998例原发性早期EEC患者。根据中华医学会（CDC）的诊断标准将患者分为不同的代谢组。比较不同代谢状态患者的无进展生存期（PFS）。同时，我们建立了EC预后相关代谢评分（ECPRM评分）来探讨代谢状态的严重程度与早期EEC PFS的相关性。建立了预测PFS的列线图，并在包括296例患者的测试集中进行了外部验证。部分代谢紊乱和MetS是早期EEC患者生存不良的独立危险因素[风险比（HR）= 7.6，95%CI = 1.01-57.5，p < 0.05]。ECPRM评分越高，PFS越低（HR = 2.1，95% CI = 1.05-4.0，p < 0.001）。ECPRM评分对预后的贡献最大的诺模图显示出内部和外部验证支持的良好的生存区分。此外，校准曲线支持其稳健的预测能力。即使他们不符合MetS的标准，部分代谢紊乱也与早期EEC的不良结局相关。ECPRM评分有利于临床医生评估代谢异常的严重程度，指导患者改善预后不良的代谢紊乱。
Patients with endometrial cancer (EC) combined with metabolic syndrome (MetS) have a worse prognosis than those without MetS. This study aimed to investigate whether partial metabolic disorder significantly influenced early-stage endometrioid EC (EEC) survival and searched for a more efficient method to evaluate metabolic status. This is a nationwide, multicenter cohort study that included 998 patients with primary early-stage EEC from 2001 to 2018. Patients were divided into different metabolic groups based on the diagnostic criteria of the Chinese Medical Association (CDC). The progression-free survival (PFS) time was compared between various metabolic status. Meanwhile, we established an EC Prognostic-Related Metabolic Score (ECPRM Score) to explore the association of the severity of metabolic status and early-stage EEC PFS. A nomogram was established for predicting PFS, which was externally validated in a testing set that includes 296 patients. A partial metabolic disorder, as well as MetS, was an independent risk factor of poor survival of patients with early-stage EEC [hazard ratio (HR) = 7.6, 95% CI = 1.01–57.5, p < 0.05]. A high ECPRM Score was associated with lower PFS (HR = 2.1, 95% CI = 1.05–4.0, p < 0.001). The nomogram, in which the ECPRM Score contributed most to the prognosis, exhibited excellent discrimination of survival supported by the internal and external validations. In addition, the calibration curve supports its robust predicting ability. Even though they do not meet the criteria of MetS, partial metabolic disorders were also associated with adverse outcomes in early-stage EEC. The ECPRM Score is beneficial for clinicians to evaluate the severity of metabolic abnormalities and guide patients to ameliorate the poor prognosis of metabolic disorders.
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影响因子：
16.2
作者：
Esposito K;Chiodini P;Colao A;Lenzi A;Giugliano D
通讯作者：
Giugliano D
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影响因子：
4.2
作者：
He S;Fang X;Xia X;Hou T;Zhang T
通讯作者：
Zhang T
影响因子：
5.8
作者：
Lu, Jieli;Wang, Limin;Ning, Guang
通讯作者：
Ning, Guang
影响因子：
2.1
作者：
DeBoer, Mark D.;Gurka, Matthew J.
通讯作者：
Gurka, Matthew J.
影响因子：
9.8
作者：
Gurka, Matthew J.;Lilly, Christa L.;Oliver, M. Norman;DeBoer, Mark D.
通讯作者：
DeBoer, Mark D.