非小细胞肺癌发生淋巴结转移风险分析及生存预后nomogram预测模型构建  

Analysis on the risk of lymph node metastasis in NSCLC and construction of a nomogram prediction model for survival and prognosis

作　　者：叶佳乐 姚萍丽[1] 陈凯 施雪霏 YE Jiale;YAO Pingli;CHEN Kai;SHI Xuefei(Department of Respiratory and Critical Care Medicine,Huzhou Central Hospital,Affiliated Central Hospital of Huzhou Normal University,Huzhou313000,China)

机构地区：[1]湖州市中心医院湖州师范学院附属中心医院呼吸与危重症医学科,浙江湖州313000

出　　处：《中国现代医生》2022年第4期22-26,共5页China Modern Doctor

基　　金：国家自然科学基金委员会资助项目(81602003)。

摘　　要：目的非小细胞肺癌特征预测淋巴结转移及死亡风险与列线图模型的构建。方法对2013年1月至2015年1月就诊于湖州市中心医院诊断为非小细胞肺癌患者的临床资料进行回顾性分析。100例患者被纳入研究,根据是否存在淋巴结转移分组,进行单因素和多因素分析。基于生存分析确定独立危险因素并构建nomogram预测模型。结果单因素分析显示,淋巴结转移与患者年龄、肿瘤大小、周边组织侵犯情况、癌胚抗原含量、血管内皮生长因子含量、基质金属蛋白酶-9含量和微血管密度含量相关(P<0.05)。多因素分析显示,肿瘤大小、侵犯主支气管、癌胚抗原、血管内皮生长因子、基质金属蛋白酶-9和微血管密度含量是非小细胞肺癌发生淋巴结转移的独立影响因素。构建的风险评估列线图模型与校准图具有良好的一致性。血管内皮生长因子和基质金属蛋白酶-9在预测非小细胞肺癌发生淋巴结转移后死亡中具有一定效能,但微血管密度在非小细胞肺癌发生淋巴结转移后死亡的预测的真实性较低。结论本研究成功构建的非小细胞肺癌患者淋巴结转移风险评估列线图模型可用于NSCLC淋巴结转移风险的预测,血管内皮生长因子和基质金属蛋白酶-9在预测非小细胞肺癌发生淋巴结转移后死亡中具有积极作用。Objective To analyze the predictive value of the features of non-small cell lung cancer(NSCLC)on lymph node metastasis and risk of death,and to construct a nomogram model.Methods The clinical data of patients diagnosed with NSCLC attending Huzhou Central Hospital from January 2013 to January 2015 were retrospectively analyzed.A total of 100 patients were included in this study and grouped according to the presence or absence of lymph node metastasis for univariate and multivariate analyses.The independent risk factors were identified and a nomogram prediction model was constructed based on survival analysis.Results Univariate analysis showed that tumor size,lymph node metastasis was associated with patient age,tumor size,peripheral tissue invasion,carcinoembryonic antigen content,vascular endothelial growth factor content,matrix metalloproteinase-9 content,and microvessel density(P<0.05).Multivariate analysis showed that invasion the main bronchus,carcinoembryonic antigen,vascular endothelial growth factor,matrix metalloproteinase-9,and microvessel density were independent influencing factors for the development of lymph node metastasis in NSCLC.The constructed nomogram model for risk assessment was in good consistency with the calibration chart.Both the vascular endothelial growth factor and matrix metalloproteinase-9 showed certain efficiency in predicting death after the development of lymph node metastasis in NSCLC,but microvessel density was less authentic in predicting death after the development of lymph node metastasis in NSCLC.Conclusion The nomogram model for lymph node metastasis risk assessment in patients with NSCLC successfully constructed during this study can be used for the prediction of lymph node metastasis risk in NSCLC,and both the vascular endothelial growth factor and matrix metalloproteinase-9 have a positive effect in predicting death after the development of lymph node metastasis in NSCLC.

关 键 词：非小细胞肺癌 淋巴结转移 生存预后 风险预测模型 

分 类 号：R730.7[医药卫生—肿瘤]