基于外周血TLR4、NLR水平构建预测喉癌患者淋巴结转移的列线图模型  

Based on Peripheral Blood TLR4 and NLR Levels,A Nomogram Model was Constructed to Predict Lymph Node Metastasis in Patients with Laryngeal Cancer

作　　者：付晴 FU Qing(Zhumadian Central Hospital,Zhumadian,463000)

机构地区：[1]河南省驻马店市中心医院,463000

出　　处：《实用癌症杂志》2024年第12期2073-2077,共5页The Practical Journal of Cancer

摘　　要：目的基于外周血Toll样受体4(TLR4)、中性粒细胞/淋巴细胞比值(NLR)水平构建预测喉癌患者淋巴结转移的列线图模型。方法选取100例喉癌患者为研究对象,根据是否发生淋巴结转移分为发生淋巴结转移组(37例)和未发生淋巴结转移组(63例)。比较2组患者的外周血TLR4、NLR水平,多因素逐步Logistic回归分析法分析影响喉癌患者淋巴结转移的危险因素;使用R3.5.3软件绘制喉癌患者淋巴结转移的风险列线图模型,并应用受试者工作曲线(ROC)下面积对风险列线图模型预测效能进行检验,利用Bootstrap法检验模型的准确性。结果发生淋巴结转移组较未发生淋巴结转移组外周血TLR4、NLR水平更高,差异均具有统计学意义(P<0.05)。单因素分析显示,发生淋巴结转移组在肿瘤部位、分化程度、临床分期、治疗方式等方面与未发生淋巴结转移组比较,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,肿瘤部位、分化程度、临床分期、治疗方式、外周血TLR4及NLR水平均是喉癌患者发生淋巴结转移的影响因素(P<0.05)。将上述影响因素作为预测变量进行喉癌患者发生淋巴结转移的列线图风险模型的构建,Bootstrap法内部验证结果显示,C-index指数为0.809(95%CI:0.743~0.858),表明区分度良好;ROC曲线结果显示,ROC曲线下面积、灵敏度、特异度分别为0.824、82.63%、78.95%,表明该模型预测效能良好。结论外周血TLR4、NLR水平与喉癌患者淋巴结转移有一定相关性,基于外周血TLR4、NLR水平构建预测喉癌患者淋巴结转移的列线图模型具有较好的预测效能。Objective To construct a nomogram model for predicting lymph node metastasis in patients with laryngeal cancer based on Toll-like receptor 4(TLR4)and neutrophil/lymphocyte ratio(NLR)levels in peripheral blood.Methods A total of 100 patients with laryngeal cancer were selected as the research objects.According to whether lymph node metastasis occurred or not,the patients were divided into the lymph node metastasis group(37 cases)and the lymph node metastasis group(63 cases).The levels of TLR4 and NLR in peripheral blood were compared between the two groups,and the risk factors of lymph node metastasis in patients with laryngeal cancer were analyzed by multi-factor stepby-step Logistic regression analysis.R3.5.3 software was used to draw the nomogram model of lymph node metastasis in patients with laryngeal cancer,and the area under receiver operating curve(ROC)was used to test the prediction efficiency of the risk nomogram model,and the accuracy of the model was tested by Bootstrap method.Results The levels of TLR4 and NLR in peripheral blood of the group with lymph node metastasis were higher than those of the group without lymph node metastasis,and the differences were statistically significant(P<0.05).Univariate analysis showed that there were significant differences in tumor location,differentiation,clinical stage and treatment mode between the group with lymph node metastasis and the group without lymph node metastasis(P<0.05).Multivariate Logistic regression analysis showed that tumor location,differentiation degree,clinical stage,treatment style,TLR4 and NLR levels in peripheral blood were all influence factors for lymph node metastasis in laryngeal cancer patients(P<0.05).The above factors were used as predictive variables to construct a nomogram model for lymph node metastasis in laryngeal cancer patients.The internal verification result of Bootstrap method showed that the C-index was 0.809(95%CI:0.743~0.858),indicating good differentiation.The ROC curve results showed that the area,sensitivity and specif

关 键 词：TLR4 NLR 喉癌 淋巴结转移 列线图模型 

分 类 号：R739.65[医药卫生—肿瘤]