The Study Of Disease Burden Of Central Nervous System Tumors And The Construction Of The Nomogram Of Low Grade Gliomas

Objective:The global Burden of Disease(GBD)database was used to analyze the disease burden of central nervous system tumors of China and globally from 1990 to 2019;a nomogram was established through the surveillance,epidemiology and prognosis(Surveillance,Epidemiology,and End Results;SEER)database to analyze the prognostic factors of low grade glioma(Low-Grade Glioma,LGG)patients and predict the survival rate.Methods:Based on publicly available data from the 2019 GBD database,we found the disease burden of central nervous system tumors of China and globally from 1990 to2019.Trends in CNS tumor burden indicators were analyzed using Joinpoint regression models,the disease burden of CNS tumors in China and globally in 2019 was analyzed using the R language-related extension package,a GM(1,1)prediction model was constructed using Matlab software to predict the incidence rate and death of CNS tumors in China after 2019;a total of 5,439 LGG patients were collected through the SEER database,and their information were counted,including age at diagnosis,sex,race,size,laterality,surgery,chemotherapy,radiotherapy histology,marital status,site of tumor and survival status.They were divided into training set(n=4438)and internal validation set(n=1001),and 67 LGG patients from Shanxi People’s Hospital between 2010 and 2017 were collected for external validation set.Using univariate,Lasso and multivariate cox regression,we analyzed independent risk factors in LGG patients.These independent predictors were integrated after considering their clinical utility.A nomogram predicting the 1-year,3-year survival rate of LGG patients was drawn by R studio(3.6.3).We examine its internal and external validation by ROC curve and the calibration curve(Calibration curve).Results:1.In 2019,the age-standardized incidence rate,age-standardized prevalence rate,age-standardized death rate and age-standardized DALYs of CNS tumors in China were all at high levels globally.2.From 1990 to 2019,the age-standardized incidence rate and age-standardized prevalence rate of CNS tumors were increasing in China.Compared with 1990,the age-standardized prevalence rate of CNS tumors increased by 177.04% in 2019 and22.58/1010000 in 2019;the age-standardized incidence rate increased by 27.92% and5.69 / 100000 in 2019.However,age-standardized death rate and age-standardized DALYs showed a downward trend.3.The GM(1,1)model predicted that the incidence rate of CNS tumors increased continuously and the death rate decreased continuously in China from 2020 to 2030.4.Univariate and Lasso-Cox regression analysis showed that age at diagnosis,histology,surgery,tumor size,marital status,chemotherapy,radiotherapy and site of tumor had a significant correlation with the prognosis of LGG patients(P<0.001).5.After nomogram is established,the 1 and 3 years area under the ROC curve of the internal validation were 0.841,0.804,and the 1 and 3 years of the external validation were 0.703,0.742;indicating the high differentiation and accuracy of the model.6.The calibration curve showed a good consistency and it was close to the 45%reference line.Conclusion:From 1990 to 2030,the burden of CNS tumors in China was increasing,and the treatment of CNS tumors in China still faced big challenges;this nomogram could estimate LGG patients’ survival rate.It had a high clinical value,and could be beneficial for the individualized treatment of LGG.