ⅠA期非小细胞肺癌患者微波消融术后肺出血的预测  

Prediction of lung hemorrhage after microwave ablation in stageⅠA non-small cell lung cancer patients

作　　者：李京朔 马盛梅 贾海鹏[1] 陈瑜娴 李春海[1] LI Jingshuo;MA Shengmei;JIA Haipeng;CHEN Yuxian;LI Chunhai(Department of Radiology,Qilu Hospital of Shandong University,Ji’nan 250012,China)

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012

出　　处：《实用放射学杂志》2024年第6期973-976,共4页Journal of Practical Radiology

摘　　要：目的建立列线图模型预测ⅠA期非小细胞肺癌(NSCLC)患者CT引导下微波消融(MWA)术后肺出血。方法将接受MWA治疗的ⅠA期NSCLC患者按照3︰1的比例随机分为训练组和验证组。在训练组中使用单因素及多因素logistic回归分析筛选肺出血的危险因素并用于列线图的建立。C指数被用来评估训练组及验证组的预测准确性。结果208例患者(训练组156例,验证组52例)被纳入研究。MWA后肺出血的危险因素分别为穿过肺实质内血管数量[比值比(OR)=3.815;95%置信区间(CI)1.485~9.800;P=0.005),病灶血供数量(OR=2.922;95%CI 1.198~7.126;P=0.018)及穿刺次数(OR=2.802;95%CI 1.792~4.381;P<0.001)。训练组的C指数为0.928(95%CI 0.875~0.963);验证组的C指数为0.906(95%CI 0.793~0.969)。肺出血的最佳截断值为0.14。结论列线图模型能有效地预测MWA术后肺出血。在列线图模型中高风险(>0.14)的患者,应警惕肺出血的发生。Objective To develop an nomogram model for predicting the lung hemorrhage after CT-guided microwave ablation(MWA)in stageⅠA non-small cell lung cancer(NSCLC)patients.Methods StageⅠA NSCLC patients treated with MWA were randomly divided into a training group and a validation group in a 3︰1 ratio.The risk factors of lung hemorrhage identified by univariable and multivariable logistic regression analysis in the training group were used to develop a nomogram model.The C-statistic was used to evaluate the predictive accuracy in both the training and validation groups.Results A total of 208 patients(training group,156 cases;validation group,52 cases)were included in this study.The risk factors of lung hemorrhage after MWA were the number of vessels passing through the lung parenchyma[odds ratio(OR)=3.815;95%confidence interval(CI)1.485-9.800;P=0.005],number of focal blood supplies(OR=2.922;95%CI 1.198-7.126;P=0.018)and number of punctures(OR=2.802;95%CI 1.792-4.381;P<0.001).The C-statistic in training group was 0.928(95%CI 0.875-0.963)and the C-statistic in validation group was 0.906(95%CI 0.793-0.969).The optimal cut-off value for lung hemorrhage was 0.14.Conclusion The nomogram model can effectively predict the lung hemorrhage after MWA.Patients showing a high risk(>0.14)on the nomogram model should be monitored for lung hemorrhage.

关 键 词：非小细胞肺癌 肺出血 微波消融 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学] R814.42