列线图模型对子宫内膜癌患者术后化疗耐受性的预测  

Prediction of postoperative chemotherapy tolerance in patients with endometrial cancer by nomogram model

作　　者：付婷 侯顺玉[1] 孙黎[1] 冷婷 梁宝权[1] 程琛[1] 秦公照 Fu Ting;Hou Shunyu;Sun Li;Leng Ting;Liang Baoquan;Cheng Chen;Qin Gongzhao

机构地区：[1]南京医科大学附属苏州医院苏州市立医院妇科,215006

出　　处：《中国医师进修杂志》2020年第12期1124-1129,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:通过对营养相关指标的分析,构建预测子宫内膜癌患者术后化疗耐受性的列线图模型。方法:收集2013年7月至2019年7月在苏州市立医院进行手术并行术后化疗的83例子宫内膜癌患者的相关临床病历资料,将营养相关的指标包括年龄、糖尿病病史、体质量指数(BMI)、白蛋白、前白蛋白、淋巴细胞计数、血红蛋白、血小板计数、C反应蛋白、总胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶等因素与患者化疗耐受性情况进行统计分析,对子宫内膜癌患者术后化疗耐受性进行预测,构建列线图模型并进行验证。结果:83例患者年龄32~81(55.15±9.38)岁,BMI 14.53~30.11(22.03±2.93)kg/m 2。83例患者术后病理均证实为子宫内膜癌,手术后均行紫杉醇+顺铂(TP方案)或紫杉醇+卡铂(TC方案)化疗。开始化疗前,对入组的83例患者进行营养风险筛查2002量表(NRS-2002)评分,有43例患者有营养不良或营养风险;接受化疗后,有34例患者出现化疗不能耐受的表现,49例患者为化疗可耐受。单因素和多因素回归分析的结果显示,糖尿病病史(HR=5.634,P=0.038)、淋巴细胞计数(HR=0.146,P=0.004)、白蛋白(HR=0.857,P=0.011)是化疗耐受性的独立影响因素。结论:糖尿病病史、淋巴细胞计数、白蛋白水平可用于预测子宫内膜癌患者对化疗耐受性,其构建的列线图模型具有较好的预测能力。Objective To construct a nomogram model to predict the tolerance of postoperative chemotherapy in endometrial cancer patients by analyzing nutrition-related indexes.Methods Patients with endometrial cancer who underwent surgery and postoperative chemotherapy in Suzhou Municipal Hospital from July 2013 to July 2019 were included in this study.Some nutrition-related indexes were collected,including age,diabetes,body mass index(BMI),blood albumin,prealbumin,lymphocyte count,hemoglobin,blood platelets,C-reactive protein and blood cholesterol,aspertate aminotransferase,alanine aminotransferase and chemotherapy tolerance.The model for prediction of postoperative chemotherapy tolerance of patients with endometrial cancer were constructed by analyzing these nutrition-related indexes.Results A total of 83 patients were enrolled,aged from 32 to 81 years,with an average age of(55.15±9.38)years,and BMI were 14.53-30.11 kg/m^2,with an average BMI of(22.03±2.93)kg/m^2.All the 83 patients were confirmed as endometrial cancer by postoperative pathology,and received TP or TC chemotherapy after surgery.Before starting chemotherapy,83 patients were scored on the NRS-2002 scale,43 were considered to be at risk of malnutrition or nutrition.After receiving chemotherapy,34 patients developed intolerance to chemotherapy,and the remaining 49 were tolerable.The results of univariate and multivariate regression analysis showed that the presence or absence of diabetes(HR=5.634,P=0.038),lymphocyte count(HR=0.146,P=0.004),and albumin(HR=0.857,P=0.011)were independent influencing factors of chemotherapy tolerance.Conclusions Diabetes mellitus,lymphocyte count and albumin level can be used to predict the tolerance of chemotherapy in patients with endometrial cancer.The nomogram model of these three nutrition-related indexeshad a good prediction ability to predict the tolerance of chemotherapy in patients with endometrial cancer.

关 键 词：营养评价 子宫内膜肿瘤 列线图 化疗耐受性 

分 类 号：R737.33[医药卫生—肿瘤]