肿瘤化疗患者恶心呕吐风险的预测模型构建及验证  

Construction and validation of a predictive model for nausea and vomiting risk in cancer chemotherapy patients

作　　者：王晶晶[1] 唐玲 Wang Jingjing;Tang Ling(Department of Oncology,Yancheng Third People's Hospital,Yancheng 224001,Jiangsu,China)

机构地区：[1]盐城市第三人民医院肿瘤科,江苏盐城224001

出　　处：《肿瘤代谢与营养电子杂志》2025年第1期83-91,共9页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的构建肿瘤化疗患者发生恶心呕吐的预测模型,并验证模型的预测效果。方法收集2022年5月至2024年5月于盐城市第三人民医院进行化疗的322例肿瘤患者的临床资料进行回顾性分析,将2022年5月至2023年6月接收的164例肿瘤化疗患者为建模组,2023年7月至2024年5月接收的158例肿瘤化疗患者为验证组,采用多因素Logistic回归建立肿瘤化疗患者恶心呕吐的风险预测模型;采用受试者操作特征(ROC)曲线评估模型的预测效果;采用Hosmer-Lemeshow(H-L)检验模型的拟合优度。结果本研究164例患者有92例出现恶心呕吐,发生率为56.10%;结果显示,年龄、性别、抑郁、肿瘤原发部位、化疗方案、肿瘤转移、化疗周期、卡诺夫斯基健康状况量(KPS)评分在发生和未发生恶心呕吐的肿瘤化疗患者之间存在统计学差异(P<0.05);多因素Logistic回归分析显示,年龄(OR=4.555)、性别(OR=4.316)、化疗方案(OR=9.473)、肿瘤转移(OR=30.379)、化疗周期(OR=3.823)、KPS评分(OR=5.623)为肿瘤化疗患者恶心呕吐发生的影响因素(P<0.05)。建模组和验证组校准曲线斜率均接近1。H-L检验建模组χ^(2)=7.884,P=0.445;验证组χ^(2)=7.356,P=0.499。ROC曲线结果显示,建模组ROC的曲线下面积为0.919,敏感度、特异度分别为85.87%、90.28%;验证组ROC曲线的曲线下面积为0.892,敏感度、特异度分别为90.22%、80.56%。结论年龄、性别、化疗方案、肿瘤转移、化疗周期、KPS评分均为肿瘤化疗患者发生恶心呕吐的影响因素,构建的预测模型区分度及有效性良好,可为临床肿瘤化疗患者治疗方案的选择提供参考。Objective To construct a predictive model for nausca and vomiting in tumor patients undergoing chemotherapy,and to verify the predictive effect of the model.Method The clinical data of 322 tumor patients who received chemotherapy in Yancheng Third People's Hospital from May 2022 to May 2024 were collected for retrospective analysis.A total of 164 patients receiving chemotherapy in the hospital from May 2022 to June 2023 were selected as the modeling group,and 158 patients receiving chemotherapy from July 2023 to May 2024 were selected as the validation group.Clinical data of patients were collected for retrospective analysis.Logistic regression was applied to establish the risk prediction model of nausea and vomiting in tumor chemotherapy patients;receiver operating characteristic(ROC)curve was applied to evaluate the predictive effect of the model;Hosmer-Lemeshow(H-L)was applied to test the goodness of fit of the model.Result In this study,92 of 164 patients had nausea and vomiting,the incidence rate was 56.10%;Univariate analysis showed that age,gender,depression,tumor primary site,chemotherapy regimen,tumor metastasis,chemotherapy eycle,and KPS score were statistically different between tumor chemotherapy patients with and without nausea and vomiting(P<0.05);multivariate Logistic regression analysis showed that age(OR=4.555),gender(OR=4.316),chemotherapy regimen(OR=9.473),tumor metastasis(OR=30.379),chemotherapy cyele(OR=3.823),KPSscore(OR=5.623)was a risk factor affecting the occurrence of nausea and vomiting(P<0.05).The slopes of the calibration curves for both the modeling group and the validation group were close to 1.H-L test modeling group χ^(2)=7.884,P=0.445;validation group χ^(2)=7.356,P=0.499.The results of the ROC curve showed that the area under the ROC curve of the modeling group was 0.919,and the sensitivity and specificity were 85.87% and 90.28%,respectively;the area under the ROC curve of the validation group was 0.892,and the sensitivity and specificity were 90.22% and 80.56%,respectively.Con

关 键 词：肿瘤 化疗 恶心 呕吐 模型 因素 列线图 预测 

分 类 号：R73[医药卫生—肿瘤]