体重指数联合分子残留病灶和结节实性成分比对ⅠB期肺腺癌术后复发的价值分析  

Value analysis of body mass index combined with molecular residual disease and consolidation tumor ratio for postoperative recurrence ofⅠB stage pulmonary adenocarcinoma

作　　者：陶天晓 朱健[1] 尹玉良 戴沈辉 TAO Tianxiao;ZHU Jian;YIN Yuliang;DAI Shenhui(Department Cardiothoracic Surgery,the First Affiliated Hospital of Anhui University of Science&TechnologyHuainan First People’s Hospital,Anhui Province,Huainan232000,China)

机构地区：[1]安徽理工大学第一附属医院安徽省淮南市第一人民医院心胸外科,安徽淮南232000

出　　处：《中国医药导报》2024年第29期10-15,共6页China Medical Herald

基　　金：安徽省质量工程立项项目(2023jyxm1078);安徽省淮南市科学计划项目(2021175)。

摘　　要：目的探讨体重指数(BMI)联合分子残留病灶(MRD)和结节实性成分比(CTR)对ⅠB期肺腺癌术后复发的预测价值。方法回顾性分析2021年1月至2023年1月安徽省淮南市第一人民医院心胸外科接受肺癌根治术的215例ⅠB期肺腺癌患者的临床资料。根据患者的复发情况分为复发组和未复发组。分析ⅠB期肺腺癌术后复发的影响因素,绘制ⅠB期肺腺癌患者术后复发风险预测列线图,受试者操作特征曲线评估ⅠB期肺腺癌患者术后复发的诊断价值。结果215例患者中57例复发,占比为26.51%。两组肿瘤直径、CTR、预后营养指数(PNI)、MRD、BMI比较,差异有统计学意义(P<0.05)。CTR、MRD、BMI<18.5 kg/m^(2)是ⅠB期肺腺癌患者术后复发的影响因素(OR=70.07、1.05、6.30,P<0.05)。三者联合预测ⅠB期肺腺癌患者术后复发的曲线下面积为0.831(95%CI:0.751~0.911),灵敏度和特异度为71.9%和91.1%。结论MRD、CTR和BMI对ⅠB期肺腺癌患者术后复发有一定的预测价值,三者联合检测用于评估ⅠB期LUAD患者术后复发的效能优于单个检测指标,体现了影像学、血液学和患者身体状况联合应用的优势。Objective To explore the predictive value of body mass index(BMI)combined with molecular residual disease(MRD)and consolidation tumor ratio(CTR)for postoperative recurrence ofⅠB stage pulmonary adenocarcinoma.Methods The clinical data of 215 patients withⅠB stage pulmonary adenocarcinoma who underwent radical resection of lung cancer in the Department of Cardiothoracic Surgery,Huainan First People’s Hospital of Anhui Province from January 2021 to January 2023 were retrospectively analyzed.The patients were divided into recurrence group and non-recurrence group according to the recurrence situation.The factors influencing postoperative recurrence ofⅠB stage pulmonary adenocarcinoma were analyzed,and the postoperative recurrence risk prediction nomogram ofⅠB stage pulmonary adenocarcinoma patients was drawn,and the diagnostic value of postoperative recurrence ofⅠB stage pulmonary adenocarcinoma patients was evaluated by receiver operating characteristic curve.Results Among 215 patients,57 recurred,accounting for 26.51%.There were significant differences in tumor diameter,CTR,prognostic nutritional index(PNI),MRD,and BMI between two groups(P<0.05).CTR,MRD,and BMI<18.5 kg/m^(2)were the influencing factors for postoperative recurrence in patients withⅠB stage pulmonary adenocar-cinoma(OR=70.07,1.05,6.30,P<0.05).The area under the curve was 0.831(95%CI:0.751-0.911),sensitivity and specificity were 71.9%and 91.1%in the combined prediction of postoperative recurrence in patients withⅠB stage pulmonary adenocarcinoma.Conclusion MRD,CTR,and BMI have certain predictive value for postoperative recurrence in patients withⅠB stage pulmonary adenocarcinoma.The efficacy of the three combined tests for evaluating postoperative recurrence in patients withⅠB stage pulmonary adenocarcinoma is superior to that of a single test index,which reflects the advantages of the combined app-lication of imaging,hematology and patient’s physical condition.

关 键 词：复发 肺腺癌 ⅠB期 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]