青年型非小细胞肺癌的预后影响因素及列线图构建  

Prognostic factors and nomogram construction of young adultswith non-small cell lung cancer

作　　者：梁东敏 洪嘉源 谢宁[2] 李艳梅 谢书阳 LIANG Dongmin;HONG Jiayuan;XIE Ning;LI Yanmei;XIE Shuyang(Key Laboratory of Molecular Biology of Tumor,School of Basic Medicine,Binzhou MedicalUniversity,Yantai 264003,Shandong,P.R.China;Yantaishan Hospital Affiliated to Binzhou Medical University,Yantai 264003,Shandong,P.R.China)

机构地区：[1]滨州医学院基础医学院,山东省高校肿瘤分子生物学重点实验室,山东烟台264003 [2]滨州医学院附属烟台山医院,山东烟台264003

出　　处：《滨州医学院学报》2022年第3期165-170,共6页Journal of Binzhou Medical University

基　　金：国家自然科学基金(81772281);山东省自然科学基金(ZR2019MH022,ZR2020KH015)。

摘　　要：目的研究青年型非小细胞肺癌(NSCLC)患者预后影响因素,构建可视化预后列线图,以期改善其预后,为个体化预后干预提供科学依据。方法从监测、流行病学和最终结果(SEER)数据库获取临床患者资料后,随机划分训练集和验证集,对训练集应用多因素Cox比例风险模型分析影响因素,构建列线图模型,从区分度、校准度和临床价值三方面对模型进行全面评价。结果美国癌症联合委员会(AJCC)分期、手术、病理类型、肿瘤大小、骨转移、放疗等是青年型NSCLC患者预后的影响因素。构建的列线图模型区分度较高,训练集3年和5年总生存率(OS)的曲线下面积(AUC)分别为0.911和0.926,验证集分别为0.882和0.856。模型预测的OS与实际OS均具有较高的一致性。决策曲线分析(DCA)结果表明临床净获益较高。结论构建的青年型NSCLC患者可视化预后列线图模型,经评价模型较好,可用于临床实践中青年型NSCLC个体化预后干预。Objective To study the prognostic factors of young patients with non-small cell lung cancer(NSCLC),construct a visual prognostic nomogram in order to improve their prognosis and provide scientific basis for individualized prognostic intervention.Methods The clinical patients data were obtained from the Surveillance,Epidemiology and End Results(SEER)database,and the training set and validation set were randomly divided;the multi-factor Cox proportional hazard model was applied to the training set to analyzethe influencing factors,construct the nomogram model,and the model was comprehensively evaluated from three aspects:differentiation,calibration and clinical value.Results American Joint Committee on Cancer(AJCC)staging,surgery,pathological type,tumor size,bone metastasis,and radiotherapy were the influencing factors for prognosis of young NSCLC patients.The nomogrammodel constructed had a higher differentiation.The area under curve(AUC)of 3-year and 5-year overall survival(OS)in the training set were 0.911 and 0.926 respectively,and those in the validation set were 0.882 and 0.856 respectively.The OS predicted by the model was consistent with the actual OS and the results of decision curve analysis(DCA)showed that the clinical net benefit was high.Conclusion The visual prognostic nomogram model was constructed for young NSCLC patients,which is evaluated to be good and can be used for individualized prognostic intervention of young patients with NSCLC in clinical practice.

关 键 词：非小细胞肺癌 SEER数据库 预后 列线图 

分 类 号：R734.2[医药卫生—肿瘤]