摘要
目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺癌的临床特点,并构建其风险预测列线图模型。方法 回顾性分析125例COPD合并肺癌患者(COPD合并肺癌组)和122例单纯COPD患者(COPD组)的临床资料,包括:年龄、性别、体重指数(body mass index,BMI)、吸烟指数、COPD时间、临床症状、相关检验指标及肺癌的病理类型等;使用SPSS 27.0对数据进行单因素及多因素Logistic回归分析筛选出独立危险因素,并通过R软件建立列线图预测模型。最后对模型进行评估。结果 列线图模型由6项危险因素组成,分别为年龄≥65岁、吸烟指数≥800年支、COPD时间、胸痛、咯血和血小板计数,ROC曲线下面积为0.879(95%CI 0.836~0.922),该预测模型在训练集(敏感度为0.840,特异度为0.828,AUC为0.879)和内部验证集(敏感度为0.838,特异度为0.848,AUC为0.885)均表现良好的性能,此外校准曲线代表了该模型的良好校准度。结论 基于慢性阻塞性肺疾病合并肺癌的6项危险因素建立的列线图预测模型具有良好的性能,对COPD患者中肺癌的高危人群筛查具有一定的指导价值。
Objective To analyze the clinical characteristics of chronic obstructive pulmonary disease(COPD)complicated with lung cancer,and to construct a risk prediction nomogram model.Methods The clinical data of 125 COPD patients complicated with lung cancer(COPD complicated with lung cancer group)and 122 patients with COPD alone(COPD group)were retrospectively analyzed,including age,gender,body mass index(BMI),smoking index,COPD duration,clinical symptoms,related laboratory indicators and pathological types of lung cancer.Univariate and multivariate Logistic regression analyses were performed on the data using SPSS 27.0 to screen out independent risk factors,and a nomogram prediction model was established by R software.Finally,the model was evaluated.Results The nomogram model consisted of six risk factors,including age≥65,smoking index≥800,COPD duration,chest pain,hemoptysis,and platelet count.The area under the ROC curve was 0.879(95%CI 0.836~0.922).The predictive model performed well in both the training set(sensitivity 0.840,specificity 0.828,AUC 0.879)and the internal validation set(sensitivity 0.838,specificity 0.848,AUC 0.885).In addition,the calibration curve represented the good calibration of the model.Conclusion The nomogram prediction model based on six risk factors of COPD complicated with lung cancer has a good performance,which has a certain guiding value for the screening of high-risk groups of lung cancer in COPD patients.
作者
秦士想
叶永青
QIN Shixiang;YE Yongqing(Graduate School,Bengbu Medical College,Bengbu,Anhui 233030,China;Department of Respiratory and Critical Care Medicine,The Luan Hospital affiliated with Anhui Medical University(Luan People’s Hospital),Luan,Anhui 237000,China)
出处
《临床肺科杂志》
2023年第11期1682-1686,共5页
Journal of Clinical Pulmonary Medicine
关键词
慢性阻塞性肺疾病
肺癌
临床特点
列线图
预测模型
chronic obstructive pulmonary disease
lung cancer
clinical characteristics
nomogram
prediction model
