摘要
目的探讨非小细胞肺癌(NSCLC)肝转移患者预后影响因素,构建预测模型,为临床早期针对性干预提供指导。方法回顾性分析湖州市中心医院2016年1月至2022年10月收治的106例NSCLC肝转移患者临床资料,统计患者1年生存情况,将患者划分为死亡组、生存组。比较两组临床资料,应用Logistic回归分析确定患者预后的独立危险因素,依据独立危险因素构建风险预测模型,应用受试者操作特征(ROC)曲线分析各独立危险因素及风险预测模型对预后的预测效能,并应用交叉验证法对风险预测模型的预测价值进行检验。结果本组106例NSCLC肝转移患者1年死亡77例(死亡组);生存29例(生存组)。两组年龄、Karnofsky功能状态(KPS)评分、肝转移灶数量、合并其他部位转移、原发病灶控制情况、治疗方式比较,差异有统计学意义(P<0.05);Logistic回归分析显示,年龄、KPS评分、合并其他部位转移、原发病灶控制情况、治疗方式均为患者预后死亡的独立危险因素(P<0.05);ROC曲线分析显示,年龄、KPS评分、合并其他部位转移、原发病灶控制情况、治疗方式均对NSCLC肝转移患者预后死亡具有一定预测意义,曲线下面积(AUC)分别为0.679、0.635、0.626、0.646、0.624;依据独立危险因素构建风险预测模型,风险预测模型的AUC为0.919,标准误差为0.028,95%CI:0.863~0.975,P<0.001。应用交叉验证法检验显示,风险预测模型对预后的分类准确率为88.68%。结论年龄、KPS评分、合并其他部位转移、原发病灶控制情况、治疗方式是NSCLC肝转移患者预后死亡的独立危险因素,据此建立的风险预测模型对患者预后死亡的预测效果较好。
Objective To investigate the prognostic factors of non-small cell lung cancer(NSCLC)patients with liver metastases,and to construct a predictive model to provide guidance for early clinical intervention.Methods The clinical data of 106 patients with liver metastases from NSCLC admitted to Huzhou Central Hospital from January 2016 to October 2022 were retrospectively analyzed.The 1-year survival of the patients was counted,and the patients were divided into the death group and the survival group.The clinical data of the two groups were compared.Logistic regression analysis was used to identify independent risk factors for patient prognosis,and a risk prediction model was constructed based on independent risk factors.The receiver operating characteristic(ROC)curve was used to analyze the predictive performance of each independent risk factor and risk prediction model for prognosis,and the cross-validation method was used to test the predictive value of the risk prediction model.Results Among the 106 NSCLC patients with liver metastases in this group,77 died within 1 year and were classified as the death group;29 survived and were classified as the survival group.There were significant differences in age,Karnofsky functional status(KPS)score,number of liver metastases,metastases in other sites,control of primary lesions,and treatment methods between the two groups(P<0.05);Logistic regression analysis showed that age,KPS score,metastases in other sites,control of primary lesions,and treatment methods were all independent risk factors for the prognosis of death of patients(P<0.05);ROC curve analysis showed that age,KPS score,combined with metastases at other sites,control of primary lesions,and treatment methods had certain predictive significance for the prognostic death of NSCLC patients with liver metastases,the areas under the curve(AUC)were 0.679,0.635,0.626,0.646,and 0.624 respectively;a risk prediction model was constructed based on independent risk factors.The AUC of the risk prediction model was 0.919,the standard error was 0.028,and the 95%CI was 0.863-0.975,P<0.001.The cross-validation test showed that the classification accuracy of the risk prediction model for prognosis was 88.68%.Conclusion Age,KPS score,metastases in other sites,control of primary lesions,and treatment methods are independent risk factors for the prognostic death of patients with NSCLC liver metastases,the risk prediction model based on these factors shows good predictive efficacy for patient prognostic death.
出处
《浙江临床医学》
2023年第9期1283-1286,共4页
Zhejiang Clinical Medical Journal
基金
国家自然科学基金资助项目(81602003)。
关键词
非小细胞肺癌
肝转移
预后
预测模型
Non-small cell lung cancer
Liver metastasis
Prognosis
Prediction model
