RESUMEN
BACKGROUND: Although determining the recurrence of cutaneous squamous cell carcinoma (cSCC) is important, currently suggested systems and single biomarkers have limited power for predicting recurrence. OBJECTIVE: In this study, combinations of clinical factors and biomarkers were adapted into a nomogram to construct a powerful risk prediction model. METHODS: The study included 145 cSCC patients treated with Mohs micrographic surgery. Clinical factors were reviewed, and immunohistochemistry was performed using tumor tissue samples. A nomogram was constructed by combining meaningful clinical factors and protein markers. RESULTS: Among the various factors, four clinical factors (tumor size, organ transplantation history, poor differentiation, and invasion into subcutaneous fat) and two biomarkers (Axin2 and p53) were selected and combined into a nomogram. The concordance index (C-index) of the nomogram for predicting recurrence was 0.809, which was higher than that for the American Joint Committee on Cancer (AJCC) 7th, AJCC 8th, Brigham and Women's Hospital, and Breuninger staging systems in the patient data set. CONCLUSION: A nomogram model that included both clinical factors and biomarkers was much more powerful than previous systems for predicting cSCC recurrence.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias Cutáneas , Humanos , Femenino , Carcinoma de Células Escamosas/cirugía , Carcinoma de Células Escamosas/patología , Nomogramas , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Estadificación de Neoplasias , Recurrencia Local de Neoplasia/patología , Biomarcadores , PronósticoRESUMEN
BACKGROUND: Several studies have indicated that combinations of lifestyle and dietary factors are associated with risk of total mortality and death from cardiovascular disease and cancer, but limited data are available from long-term follow-up studies in China. METHODS: This study was a observational cohort study. We prospectively examined the associations of combined lifestyle factors and risk of total and cause-specific mortality in the Linxian General Population Nutrition Intervention Trial (NIT) cohort that included 29,584 healthy adults. A points system method was used to calculate a combined risk score of five lifestyle factors, including smoking, alcohol drinking, body mass index, vegetable intake and fruit intake. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: Overall, adjusted hazard ratios for mortality increased progressively with an increasing combined risk score. Compared to individuals with a score of zero or one, HRs (95%CIs) for a score of five or above were 1.59 (1.44-1.75) for all-cause mortality, 1.67 (1.48-1.88) for heart disease, 1.69 (1.52-1.88) for stroke, and 1.34 (1.21, 1.47) for cancer. This association for mortality was seen consistently, regardless of gender and age at baseline. CONCLUSIONS: A higher combined risk score was positively associated with risk of total, heart disease, stroke, and cancer mortality. These findings could provide further evidence for the idea that healthy lifestyle is the optimal way to reduce the risk of premature death, and encourage behavior change.