Risk factors and predictors for tumor site origin in metastatic adenocarcinoma of unknown primary site.
Risk factors and predictors for tumor site origin in metastatic adenocarcinoma of unknown primary site.
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DOI：
10.1002/cam4.3684
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发表时间：
2021-03
期刊：
影响因子：
4
通讯作者：
Sun L
中科院分区：
文献类型：
--
作者：
Li X;Shao Y;Sheng L;Zhu J;Wang Z;Guo K;Sun L
原发部位不明的转移性腺癌（MACUP）是最常见的原发部位不明的恶性肿瘤，预后较差。肿瘤部位来源的预测越来越受到人们的关注。然而，通过基因表达谱确定的位点对存活率没有显著影响。可能需要找到其他一些特殊的方法。我们回顾了2010-2016年期间基于监测、流行病学和最终结果（SEER）数据库通过病理检查和免疫组化诊断的1011例MACUP患者。采用Kaplan-Meier曲线和考克斯比例风险模型分析生存率。应用Logistic回归模型和列线图预测原发部位为消化系统、呼吸系统和女性乳腺的概率。模型的有效性和临床实用性用相关的统计方法来衡量。大约324例（32.1%）、299例（29.6%）和203例（20.1%）MACUP患者分别被确定为消化系统、呼吸系统和女性乳房的原发部位。来源于消化系统和呼吸系统的患者生存率较其他部位差。消化系统与肝转移（比值比=13.21 [95%置信区间=8.48-21.02]）或肺转移（2.36 [1.40-3.97]）显著相关，而呼吸系统与脑转移（11.68 [6.68-21.26]）或淋巴结转移（3.39 [2.26-5.13]）相关。女性乳腺癌患者易发生骨转移（5.85 [3.68-9.45]）。开发了逻辑回归列线图，以帮助临床医生直观地预测肿瘤部位起源的概率，C指数分别为0.867、0.824和0.753。决策曲线分析和临床影响曲线均显示了临床有效性。我们分析了MACUP患者不同肿瘤部位的起源，并建立了预测模型。这些特征对临床医生提高原发灶的预测概率和制定后续治疗策略具有重要意义。我们分析了MACUP患者不同肿瘤部位的起源，并建立了预测模型。这些特征对临床医生提高原发灶的预测概率和制定后续治疗策略具有重要意义。
Metastatic adenocarcinoma of unknown primary site (MACUP) is the most common cancer of unknown primary site, and shows worse prognosis. Prediction of its tumor site origin attracts a growing attention. However, the site determined by gene expression profiling does not have a significant impact on the survival. Some other special method might need to be found out. We reviewed 1011 MACUP patients diagnosed by pathological examination and immunohistochemistry based on the Surveillance, Epidemiology, and End Results (SEER) database during 2010–2016. Kaplan–Meier curves and Cox proportional hazard model were analyzed to compare the survival. Logistic regression models and relevant nomograms were performed to predicting the probability of the primary site which including digestive system, respiratory system, and female breast. The validation and clinical utility of models were measured with relevant statistical approaches. About 324 (32.1%), 299 (29.6%), and 203 (20.1%) of MACUP patients were identified as the primary sites of digestive system, respiratory system, and female breast, respectively. Patients derived from digestive system and respiratory system showed poorer survival than these with other sites. Digestive system was significantly associated with liver (Odds ratio =13.21 [95% confidence interval =8.48–21.02]) or lung (2.36 [1.40–3.97]) metastasis, while respiratory system was linked to brain (11.68 [6.68–21.26]) or lymph node (3.39 [2.26–5.13]) metastasis. Patients identified as female breast were prone to occur bone metastasis (5.85 [3.68–9.45]). Logistic regression nomograms were developed to help clinicians intuitively predict the probabilities of tumor site origin with 0.867, 0.824, and 0.753 of the C‐index, respectively. Decision curve analysis and clinical impact curves both revealed the clinical effectiveness. We profiled different tumor site origin of MACUP patients and established prediction models. These features might be significant for clinicians to improve the probabilities of predicting the primary sites, and to decide subsequent treatment strategy. We profiled different tumor site origin of MACUP patients and established prediction models. These features might be significant for clinicians to improve the probabilities of predicting the primary sites, and to decide subsequent treatment strategy.
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DOI：
10.1016/s1470-2045(14)71116-7
发表时间：
2015-04
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Balachandran VP;Gonen M;Smith JJ;DeMatteo RP
通讯作者：
DeMatteo RP
影响因子：
8.4
作者：
El Rassy, Elie;Khaled, Hussein;Pavlidis, Nicholas
通讯作者：
Pavlidis, Nicholas
影响因子：
50.5
作者：
Hemminki, K.;Bevier, M.;Sundquist, J.
通讯作者：
Sundquist, J.
影响因子：
168.9
作者：
Pavlidis, Nicholas;Pentheroudakis, George
通讯作者：
Pentheroudakis, George
影响因子：
4
作者：
Guo, Kaibo;Feng, Yuqian;Ruan, Shanming
通讯作者：
Ruan, Shanming