预后营养指数对接受放疗的老年非小细胞肺癌患者生存的预测价值及列线图的构建  

Predictive value of prognostic nutrition index and construction of a nomogram for survival in elderly patients with non-small cell lung cancer receiving radiotherapy

作　　者：杜星语 张同梅[2] 田翠孟[1] Du Xingyu;Zhang Tongmei;Tian Cuimeng(Department of Radiation Oncology,Beijing Chest Hospital,Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China;Department of Oncology,Beijing Chest Hospital,Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所放射治疗科,北京101149 [2]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所肿瘤科,北京101149

出　　处：《中华老年医学杂志》2025年第3期317-323,共7页Chinese Journal of Geriatrics

摘　　要：目的探讨预后营养指数(prognostic nutrition in-dex,PNI)对接受放疗的70岁及以上的老年非小细胞肺癌(non-small cell lung cancer,NSCLC)患者总生存的实际临床应用价值,构建列线图预测模型。方法收集经过病理确诊的144例70岁及以上NSCLC患者的一般临床病理特征和采集外周血的血常规资料,并计算放疗前患者的PNI(血清白蛋白+5×淋巴细胞计数),分析影响这部分患者生存的预后因素,使用R语言4.0.3软件进行统计学分析,构建列线图模型并进行验证。结果125例NSCLC老年患者符合纳入标准,全组患者的中位生存时间为18.4个月,计算得出PNI的最佳截断值为42.3。PNI与接受放疗的老年NSCLC患者的年龄、化疗、免疫治疗和放射性肺炎密切相关(P<0.05)。TNM分期、化疗、免疫治疗和PNI为影响70岁及以上接受过放疗的NSCLC患者预后的独立因素(P<0.05)。将上述独立危险因素用来构建患者1、2和3年的预后列线图,使用Bootstrap重复抽样1000次,并通过ROC曲线和校准曲线进行验证。结论对于70岁及以上接受过放疗的NSCLC患者,PNI是一个简便的预测预后的指标,具有实用的临床应用价值。ObjectiveTo investigate the clinical value of prognostic nutrition index(PNI)in the overall survival of patients with non-small cell lung cancer(NSCLC)aged 70 years and above treated with radiotherapy,and to construct a nomogram prediction model.MethodsGeneral clinicopathological features and routine blood test in144 patients with pathologically confirmed NSCLC aged 70 years and above were collected,PNI(serum albumin+5×lymphocyte count)before radiotherapy were calculated,and prognostic factors affecting the survival were analyzed.Build a nomogram model and verify it.Statistical analysis was performed using R language 4.0.3 software.Results125 elderly patients with NSCLC met the inclusion criteria,with the median survival time of 18.4 months.The optimal cutoff value of PNI was 42.3.PNI was closely correlated with age,chemotherapy,immunotherapy and radiation pneumonia in elderly NSCLC patients receiving radiotherapy(P<0.05).TNM stage,chemotherapy,immunotherapy and PNI were independent factors affecting the prognosis of NSCLC patients aged 70 years and above who had received radiotherapy(P<0.05).We use these independent risk factors to construct prognostic column charts at 1,2,and 3 years.We use Bootstrap repeated sampling 1000 times,and validate through ROC curves and calibration curves.ConclusionsFor NSCLC patients aged 70 years and above who have received radiotherapy,PNI is a simple prognostic indicator and has practical clinical application value.

关 键 词：预后营养指数 放射治疗 非小细胞肺癌 老年 

分 类 号：R73[医药卫生—肿瘤]