摘要
目的 通过整合患者基本信息和临床数据,开发和验证一种预测模型,用于预测个体晚期非小细胞肺癌(NSCLC)患者的5年生存率。方法 从山西省肿瘤医院收集313例晚期NSCLC患者的临床资料,以7∶3的比例随机分配到训练队列和内部验证队列。采用单因素和多因素的Cox回归分析筛选出影响患者5年生存率的独立因素并创建预测模型。使用一致性指数(C-index)、校准曲线和受试者操作特征(ROC)曲线评估模型的性能,并使用临床决策曲线(DCA)对预测模型临床获益程度进行模型效能评估。创建列线图以可视化患者的5年生存预测概率。结果 创建了一个较好的预后模型并绘制了模型可视化列线图。列线图由9个变量构建:年龄、吸烟史、N分期、骨转移、血小板计数、淋巴细胞绝对值、乳酸脱氢酶(LDH)、Ki67和一线治疗方案。根据训练队列的中位风险评分,将所有个体分为高风险组和低风险组,高风险组在两个队列中总生存期(OS)均较差(P<0.05)。结论 建立了一个临床预测模型,用于预测晚期NSCLC患者的5年生存率。
Objective To develop and validate a prediction model for the 5-year survival rate of patients with advanced non-small cell lung cancer(NSCLC)by integrating the basic information and clinical data of patients.Methods A total of 313 patients with advanced NSCLC from the Cancer Hospital of Shanxi Medical University were randomly assigned(7∶3)to a training cohort and an internal validation cohort.Univariate and multivariate Cox regression analyses were performed to screen out the independent factors that affect the 5-year survival rate of patients and create a prediction model.The perfor-mance of the model 0020 was evaluated using the consistency index(C-index),calibration curve,and receiver operating characteristic(ROC)curve.The clinical decision curve analysis(DCA)was used to assess the clinical benefit of the predic-tion model.A nomogram was also created to visualize the predicted probability of 5-year survival.Results A good prognos-tic model was developed and a nomogram for model visualization was plotted.The nomogram was constructed with nine vari-ables:age,smoking history,N stage,bone metastasis,platelet count,lymphocyte count,lactate dehydrogenase,Ki67,and first-line treatment regimen.Based on the median risk score of the training cohort,all individuals were divided into high-risk group and low-risk group,and the high-risk group had poor overall survival(OS)in both cohorts(P<0.05).Conclusion A clinical prediction model was established to predict the 5-year survival rate of patients with advanced NSCLC.
作者
郑克澳
郝志英
李方钰
徐婷婷
张俊艳
ZHENG Ke’ao;HAO Zhiying;LI Fangyu;XU Tingting;ZHANG Junyan(School of Pharmacy,Shanxi Medical University,Taiyuan,030001,Shanxi,China;Shanxi Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,030013,Shanxi,China)
出处
《肿瘤药学》
2024年第6期738-746,共9页
Anti-Tumor Pharmacy
基金
国家肿瘤区域医疗中心科教培育基金(SD2023027)
2024年山西省财政补助中医药资金(zyytd2024019)。
关键词
非小细胞肺癌
预后模型
5年生存期
靶向药物
化疗药物
Non-small cell lung cancer
Prognostic model
Five-year survival
Targeted drug
Chemotherapy drug
