基于术前纤维蛋白原/前白蛋白比值、白蛋白/球蛋白比值检测建立NSCLC患者术后短期预后的预测模型  

A nomogram to predict short-term postoperative prognosis of non-small cell lung cancer based on preoperative fibrinogen-to-prealbumin ratio and albumin-to-globulin ratio

作　　者：杨璨 胡海峰[2] 曹强[2] Yang Can;Hu Haifeng;Cao Qiang(Department of Medical Laboratory,Xi'an International Medical Center Hospital,Xi'an 710100,China;Department of Thoracic Surgery,Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]西安国际医学中心医院医学检验科,西安710100 [2]延安大学附属医院胸外科,延安716000

出　　处：《国际呼吸杂志》2024年第11期1265-1270,共6页International Journal of Respiration

基　　金：陕西省卫健委课题(2021A014)。

摘　　要：目的基于术前纤维蛋白原/前白蛋白比值(FPR)、白蛋白/球蛋白比值(AGR)检测建立非小细胞肺癌(NSCLC)患者术后短期预后的预测模型。方法本研究为回顾性队列研究。采用随机分层抽样方法, 选取2020年11月至2022年3月在西安国际医学中心医院行胸腔镜肺癌根治术的103例NSCLC患者, 对其临床资料进行分析, 记录短期总生存率。术前检测并计算FPR和AGR, 采用Cox回归模型分析影响NSCLC患者术后短期预后的相关因素, 建立预测模型, 并分析其预测价值。结果 103例NSCLC患者术后1年内存活90例(存活组), 死亡13例(死亡组), 1年总生存率为87.38%。存活组男49例(54.44%), 女41例(45.56%), 年龄(58.92±7.66)岁;死亡组男8例(61.54%), 女5例(38.46%), 年龄(57.69±8.91)岁。2组患者性别、年龄差异无统计学意义(χ^(2)=0.23, P=0.631;t=0.53, P=0.597)。2组TNM分期、组织学分化程度方面差异均有统计学意义(χ^(2)值分别为7.17、4.62, 均P<0.05)。死亡组患者血清癌胚抗原、甲胎蛋白、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值和FPR高于存活组, AGR低于存活组(均P<0.05)。Cox回归分析结果显示, 低分化程度、中性粒细胞/淋巴细胞比值和FPR升高均是NSCLC患者术后1年内死亡的独立危险因素(P<0.05), AGR升高为NSCLC患者术后1年内死亡的独立保护因素(P<0.05)。根据Cox多因素分析结果建立Nomogram预测模型, 其C指数为0.794, 受试者操作特征曲线分析结果显示, Nomogram模型判断NSCLC患者术后1年内死亡的曲线下面积为0.861(SE=0.059, 95%CI:0.746~0.976, P<0.001), 敏感度为0.846, 特异度为0.662。结论基于FPR、AGR检测建立的Nomogram模型对判断NSCLC术后1年内死亡具有较高准确性, 有助于指导临床。Objective:To create a nomogram to predict short-term postoperative prognosis of non-small cell lung cancer(NSCLC)patients based on preoperative fibrinogen-to-prealbumin ratio(FPR)and albumin-to-globulin ratio(AGR).Methods:This study was a retrospective cohort study.Totally 103 NSCLC patients who underwent thoracoscopic radical resection for lung cancer in Xi′an International Medical Center Hospital from November 2020 to March 2022 were selected by random stratified sampling method,the clinical data were analysed,and the short-term overall survival rate(OS)was recorded.The preoperative FPR and AGR levels were detected and calculated.Factors influencing the short-term prognosis of NSCLC patients after surgery were analyzed by Cox regression model.A nomogram to predict short-term prognosis of NSCLC was created and its performance was validated.Results:There were 13 deaths(death group)and 90 survivors(survival group)within one year of surgery among the 103 NSCLC patients,with the one-year OS of 87.38%.There were 49 males(54.44%)and 41 females(45.56%)in the survival group,with a mean age of 58.92±7.66 years.There were 8 males(61.54%)and 5 females(38.46%)in the death group,with a mean age of 57.69±8.91 years.There was no significant difference in gender and age between the two groups(χ^(2)=0.23,P=0.631;t=0.53,P=0.597).There were significant differences in tumor,node,metastasis(TNM)staging and histological differentiation between the two groups(χ^(2) values were 7.17 and 4.62,respectively,both P<0.05).The serum carcinoembryonic antigen(CEA),alpha fetoprotein(AFP),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and FPR of the death group were significantly higher than those of the survival group,while AGR was significantly lower than that of the survival group(all P<0.05).The Cox regression analysis results showed that low differentiation,increased NLR and increased FPR were independent risk factors for death within one year after surgery in NSCLC patients(P<0.05),while the increased AGR was a

关 键 词：肺癌 非小细胞 纤维蛋白原/前白蛋白比值 白蛋白/球蛋白比值 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]