NSCLC化疗患者消化道症状群调查及风险Nomo gram模型的构建  

Survey of gastrointestinal symptom cluster and risk factors in NSCLC chemotherapy patients and construction of nomogram model

作　　者：王雯[1] 樊国霞 崔可鑫 张彤[1] WANG Wen;FAN Guoxia;CUI Kexin;ZHANG Tong(Department of Internal Medicine,Peking University People's Hospital,Beijing,China,100044)

机构地区：[1]北京大学人民医院内科,北京100044

出　　处：《分子诊断与治疗杂志》2024年第11期2135-2138,2143,共5页Journal of Molecular Diagnostics and Therapy

基　　金：北京大学人民医院研究与发展基金项目(RDJ2022⁃15)。

摘　　要：目的探究晚期非小细胞肺癌(NSCLC)化疗患者的消化道症状群和前哨症状,并基于前哨症状的困扰风险进行Nomogram模型的构建。方法纳入2020年11月至2024年1月在北京大学人民医院接受化疗的102例晚期NSCLC患者作为研究对象。收集患者的一般资料和疾病特征,并采用安德森症状评估量表肺癌特异性模块(MDASI⁃LC)和探索性因子分析法提取晚期NSCLC化疗患者的消化道症状群,基于Apriori算法判断该症状群内的前哨症状。根据化疗过程中患者的恶心严重程度将患者分为高症状组(71例)和低症状组(31例),采用单因素和二元logistics回归分析筛选晚期NSCLC患者化疗期间出现高恶心症状的困扰因素,并构建Nomogram预测模型。结果晚期NSCLC化疗患者消化道症状群为恶心、呕吐、便秘和缺乏食欲,恶心为该症状群内的前哨症状。单因素分析及二元logistics回归多因素分析结果显示,年龄、无饮酒史、SOC评分以及含铂类化疗药物是晚期NSCLC化疗患者出现高程度恶心症状的困扰因素(P<0.05)。结论建议医护人员在临床实践中将恶心作为评估晚期NSCLC化疗患者消化道症状群的切入点,并进行提前干预。Objective To explore the gastrointestinal symptom cluster and sentinel symptom in patients with advanced non⁃small cell lung cancer(NSCLC)undergoing chemotherapy,and to perform Nomogram modeling based on the risk factors of sentinel symptom.Methods A total of 102 patients with advanced NSCLC who received chemotherapy at the People's Hospital of Peking University from November 2020 to January 2024 were included as study subjects.General information and disease characteristics of the patients were collected.The gastrointestinal symptom cluster of advanced NSCLC chemotherapy patients was extracted using the lung cancer⁃specific module of the M.D.Anderson Symptom Inventory⁃lung Cancer(MDASI⁃LC)and exploratory factor analysis.The sentinel symptom within this symptom cluster was determined based on the Apriori algorithm.Patients were divided into a high symptom group(71 cases)and a low symptom group(31 cases)according to the severity of nausea during chemotherapy.Univariate and binary logistic regression analyses were used to screen for troubling factors for high nausea symptoms during chemotherapy in patients with advanced NSCLC,and to construct a Nomogram prediction model.Results The gastrointestinal symptom cluster in patients undergoing chemotherapy for advanced NSCLC includes nausea,vomiting,constipation,and lack of appetite,with nausea being a key sentinel symptom within this cluster.Univariate and binary logistic regression multivariate analyses showed that age,lack of alcohol consumption history,sense of coherence(SOC)scale scores,and the use of platinum⁃containing chemotherapeutic agents were troubling factors for the high degree of nausea symptoms in these patients undergoing chemotherapy for advanced NSCLC(P<0.05).Conclusion Healthcare professionals are advised to use nausea as a starting point for assessing gastrointestinal symptom clusters in patients receiving chemotherapy for advanced NSCLC.It is important to intervene proactively in their clinical practice.

关 键 词：非小细胞肺癌 晚期 消化道 症状群 前哨症状 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]