[1]曹琬琪,刘亚岚,郭 旦,等.非小细胞肺癌合并肌肉减少症的危险因素分析及预测模型建立[J].医学信息,2022,35(24):63-68.[doi:10.3969/j.issn.1006-1959.2022.24.013]
　CAO Wan-qi,LIU Ya-lan,GUO Dan,et al.Risk Factors Analysis and Prediction Model Establishment of Non-small Cell Lung Cancer with Sarcopenia[J].Journal of Medical Information,2022,35(24):63-68.[doi:10.3969/j.issn.1006-1959.2022.24.013]
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非小细胞肺癌合并肌肉减少症的危险因素分析及预测模型建立()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年24期
页码:
63-68
栏目:
论著
出版日期:
2022-12-15

文章信息/Info

Title:
Risk Factors Analysis and Prediction Model Establishment of Non-small Cell Lung Cancer with Sarcopenia
文章编号:
1006-1959（2022）24-0063-06
作者:
曹琬琪; 刘亚岚; 郭 旦; 等
（南华大学衡阳医学院附属邵阳医院血液肿瘤科，湖南 衡阳 421001）
Author(s):
CAO Wan-qi; LIU Ya-lan; GUO Dan; et al.
(Department of Hematology and Oncology,Shaoyang Hospital,Hengyang Medical College,University of South China,Hengyang 421001,Hunan,China)
关键词:
肌肉减少症; 非小细胞肺癌; 列线图模型
Keywords:
Sarcopenia; Non-small cell lung cancer; Nomogram model
分类号:
R734.2
DOI:
10.3969/j.issn.1006-1959.2022.24.013
文献标志码:
A
摘要:
目的 通过探讨非小细胞肺癌患者合并肌肉减少症的危险因素，构建列线图模型预测非小细胞肺癌患者出现肌肉减少症的概率，为个体化预后干预提供参考依据。方法 选取2020年12月-2022年3月我院85例非小细胞肺癌患者作为研究对象，收集患者年龄、性别、吸烟情况、体质指数（BMI）、肿瘤病理分型，肿瘤TNM分期、血清白介素6（IL-6）、肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）水平。根据亚洲肌肉减少症工作组（AWGSOP）制定标准将患者分为肌肉减少症组及非肌肉减少症组，通过单因素分析及多因素Logistics回归分析筛选出影响非小细胞肺癌患者出现肌肉减少症的危险因素，将筛选出的危险因素纳入R软件构建列线图预测模型，采用Bootstrap方法进行内部验证。结果 85例患者肌肉减少症组40例，非肌肉减少症组45例；肌肉减少症组男性比例、鳞癌及其它类型癌比例、血清TNF-α、IL-6水平高于非肌肉减少症组，腺癌、BMI、白蛋白低于非肌肉减少症组，差异有统计学意义（P＜0.05）；两组吸烟情况、CRP水平、肿瘤分期比较，差异无统计学意义（P＞0.05）；单因素分析显示，性别、白蛋白、TNF-α、IL-6、CRP、BMI与非小细胞肺癌并发肌肉减少症相关（P＜0.05）；多因素Logistic 回归分析显示，高TNF-α、高IL-6、高CRP、低BMI是非小细胞肺癌并发肌肉减少症的独立危险因素（P＜0.05）；基于 Logistic 回归分析结果建立列线图预测模型，ROC曲线显示，该模型C指数为0.913，准确度好；校准曲线提示预测模型预测发生不良结局风险与实际发生不良结局风险的平均误差为0.036，预测结果和观察结果之间有良好的一致性。结论 基于非小细胞肺癌患者合并肌肉减少症的危险因素建立的列线图对于判断非小细胞肺癌患者的营养状态及治疗预后均具有重要意义。
Abstract:
Objective To investigate the risk factors of patients with non-small cell lung cancer complicated with sarcopenia, construct a line graph model to predict the probability of sarcopenia in patients with non-small cell lung cancer, and provide reference for individualized prognostic intervention.Methods From December 2020 to March 2022, 85 patients with non-small cell lung cancer in our hospital were selected as the research objects. The age, gender, smoking status, body mass index (BMI), tumor pathological classification, tumor TNM stage, serum interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) level and C-reactive protein (CRP) level were collected. According to the criteria established by the Asian Working Group on Sarcopenia (AWGSOP), the patients were divided into sarcopenia group and non-sarcopenia group. The risk factors affecting sarcopenia in patients with non-small cell lung cancer were screened by univariate analysis and multivariate Logistics regression analysis. The selected risk factors were included in R software to construct a nomogram prediction model, and Bootstrap method was used for internal verification.Results There were 40 patients in the sarcopenia group and 45 patients in the non-sarcopenia group. The proportion of males, the proportion of squamous cell carcinoma and other types of cancer, the levels of serum TNF-α and IL-6 in the sarcopenia group were higher than those in the non-sarcopenia group, and the adenocarcinoma, BMI and albumin were lower than those in the non-sarcopenia group (P<0.05). There was no significant difference in smoking, CRP level and tumor stage between the two groups (P>0.05). Univariate analysis showed that gender, albumin, TNF-α, IL-6, CRP, BMI were associated with sarcopenia in non-small cell lung cancer (P<0.05). Multivariate Logistic regression analysis showed that high TNF-α, high IL-6, high CRP and low BMI were independent risk factors for sarcopenia in non-small cell lung cancer (P<0.05). Based on the results of Logistic regression analysis, a nomogram prediction model was established. The ROC curve results showed that the C index was 0.913, and the accuracy was good. The calibration curve suggested that the average error between the predicted risk of adverse outcomes and the actual risk of adverse outcomes was 0.036, and there was a good consistency between the predicted results and the observed results.Conclusion The nomogram based on the risk factors of sarcopenia in patients with non-small cell lung cancer is of great significance for judging the nutritional status and treatment prognosis of patients with non-small cell lung cancer.

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更新日期/Last Update: 1900-01-01