中医药导报2023，Vol.29Issue(12)：34-39,6.DOI:10.13862/j.cn43-1446/r.2023.12.007
基于中医证型的高级别浆液性卵巢癌铂耐药复发预测模型的构建与验证
Construction and Verification of Platinum-Resistant Recurrence Prediction Model for High-Grade Serous Ovarian Cancer Based on Traditional Chinese Medicine Syndrome
摘要
Abstract
Objective:To construct and externally verify a clinical prediction model for patients with platinum-resistant recurrence of high-grade serous ovarian cancer based on traditional Chinese medicine(TCM)syndrome.Methods:Totally 273 patients with high grade serous ovarian cancer who relapsed with platinum-containing chemotherapy were retrospectively collected and divided into platinum-resistant group and platinum-sensitive group.Medical records of patients were collected in the form of questionnaire.Independent factors influencing platinum-resistant recurrence of high-grade serous ovarian cancer were selected as model predictors by univariate and multivariate logistic regression analysis.Clinical prediction model of platinum-resistant recurrence based on TCM syndrome was constructed,and the model was presented by using RStudio to make a line graph.The clinical data of 50 patients with high-grade serous ovarian cancer were prospectively collected as a validation set for external validation of the predictive model.Finally,the receiver operating characteristic curve(ROC)and calibration curve were drawn to evaluate the efficiency of the model.Results:Univariate analysis of patients with high-grade serous carcinoma showed P＜0.1 for the disease course,satisfaction with tumor reduction surgery,FIGO stage,CA125 after the last chemotherapy,lipid metabolism,lymph node metastasis and TCM syndrome.Multi-variate binary Logistic regression equation analysis showed that lipid metabolism,FIGO stage,TCM syndrome,course of disease,and CA125 level in the last chemotherapy were independent factors influencing the occur-rence of platinum resistance recurrence in ovarian cancer patients.The diagnostic threshold for platinum-resistant recurrence of high-grade serous ovarian cancer was 0.465,and the corresponding sensitivity(sensitivity)was 84.6％.And specificity was 65.7％.The x2 value of HL test was 12.479,with P＞0.05.The calibration curves of modeling set and verification set showed that the prediction model was accurate.The modeling set AUC was 0.777,and the validation set AUC was 0.758,indicating that the model had good prediction efficiency.Conclusions:The prediction of platinum resistance recurrence of high-grade serous ovarian cancer has good efficacy,which is helpful to predict the risk of platinum resistance in newly diagnosed high-grade serous ovarian cancer in clinical work.Early attention and intervention should be paid to key groups to prolong the progression-free survival time,but more effective supporting data are still needed to increase the benign performance of the prediction model.关键词
高级别浆液性卵巢癌/铂耐药复发/临床预测模型/中医证型Key words
high-grade serous ovarian cancer/platinum resistance relapse/clinical prediction model/TCM syndrome分类
医药卫生引用本文复制引用
王雅楠,卢雯平,王瑞鹏,吴晓晴..基于中医证型的高级别浆液性卵巢癌铂耐药复发预测模型的构建与验证[J].中医药导报,2023,29(12):34-39,6.基金项目
国家自然科学基金项目(81473566) （81473566）
