ω-3 PUFA在肺结节患者血清中的表达及数字预测模型的建立  

Expression of ω-3 PUFA in serum of patients with pulmonary nodules and establishment of a digital prediction model

作　　者：姚益 胡秋霞 李季 王毅 杨彦辉 李晓亮 罗雷 雷雨 谢晓阳 YAO Yi;HU Qiuxia;LI Ji;WANG Yi;YANG Yanhui;LI Xiaoliang;LUO Lei;LEI Yu;XIE Xiaoyang(Department of Cardiothoracic Surgery,the First People’s Hospital of Neijiang Neijiang Hospital Affiliated to Chongqing Medical University,Sichuan Province,Neijiang 641000,China)

机构地区：[1]四川省内江市第一人民医院重庆医科大学附属内江医院胸心外科,四川内江641000

出　　处：《中国医药导报》2023年第16期93-97,共5页China Medical Herald

基　　金：四川省卫健委员会普及应用项目(20PJ289);四川省内江市科技支撑计划项目(Z202144)。

摘　　要：目的比较ω-3多不饱和脂肪酸(ω-3 PUFA)在肺结节患者血清中表达差异,探究肺结节良恶性独立危险因素,制订良恶性概率预测模型。方法选择2018年1月至2021年12月四川省内江市第一人民医院胸心外科收治的病理明确的肺结节患者294例,将患者简单随机抽样分为建模组(201例)和验证组(93例)。比较建模组良恶性肺结节患者血清中ω-3 PUFA的表达差异。单因素、多因素分析恶性肺结节的影响因素,建立诊断预测模型并对预测模型进行验证。结果建模组肺结节良性和恶性患者在ω-3 PUFA、病灶直径、肿瘤实性成分直径比值(CTR)、短毛刺、血管征、胸膜牵拉比较,差异有统计学意义(P<0.05)。logistic回归结果显示,ω-3 PUFA、CTR、短毛刺、血管征、胸膜牵拉是判断肺结节良恶性的独立影响因素(P<0.05)。建立预测模型:P=ex/(1+ex)。X=-5.020+(0.042×ω-3 PUFA阳性)+(1.613×CTR)+(1.185×短毛刺)+(1.081×胸膜牵拉)+(0.936×血管征)。本研究模型受试者换作特征(ROC)曲线下面积(AUC)为0.837,灵敏度、特异度分别为74.5%、84.6%。验证组ROC曲线AUC为0.780。结论血清ω-3 PUFA降低、CTR≥0.5、具有毛刺征、血管征、胸膜牵拉的肺结节需高度怀疑恶性可能,所建立的诊断预测模型对肺结节良恶性具有良好预测性。Objective To compare theω-3 polyunsaturated fatty acid(ω-3 PUFA)expression in serum of patients with pulmonary nodules,and to explore the independent risk factors for benign and malignant pulmonary nodules and establish a malignant probability prediction model.Methods A total of 294 patients with pulmonary nodule with definite pathology admitted to the Department of Cardiothoracic Surgery of the First People’s Hospital of Neijiang City,Sichuan Province from January 2018 to December 2021 were selected,and the patients were randomly divided into modeling group(201 cases)and verification group(93 cases).The difference of serum expression ofω-3 PUFA in benign and malignant pulmonary nodules was compared in the modeling group.The influencing factors of malignant pulmonary nodules were analyzed by single factor and multiple factor,and the diagnosis and prediction model was established and verified.Results There were statistically significant differences inω-3 PUFA,focal diameter,consolidation/tumorratio(CTR),short burr,vascular signs and pleural pull between benign and malignant pulmonary nodules in the modeling group(P<0.05).Logistic regression showed thatω-3 PUFA,CTR,short burr,vascular sign,and pleural pull were independent influencing factors for benign and malignant pulmonary nodules(P<0.05).The prediction model was established:P=ex/(1+ex).X=-5.020+(0.042×ω-3 PUFA positive)+(1.613×CTR)+(1.185×short burr)+(1.081×pleural drag)+(0.936×vascular sign).The area under curve(AUC)of receiver operating characteristic(ROC)curve of this model was 0.837,and the sensitivity and specificity were 74.5%and 84.6%,respectively.The AUC of the ROC curve of verification group was 0.780.Conclusion Lung nodules with decreased serumω-3 PUFA,CTR≥0.5,burr sign,vascular sign,and pleural pull need to be highly suspected of malignancy.The established diagnosis and prediction model has a good prediction of benign and malignant pulmonary nodules.

关 键 词：Ω-3多不饱和脂肪酸 肺结节 肺癌 良恶性诊断 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]