肺癌术后化疗患者癌因性疲乏的Nomogram模型构建OA
Construction of a Nomogram model for cancer-related fatigue in postoperative chemotherapy patients with lung cancer
目的 分析影响肺癌术后化疗患者癌因性疲乏程度的危险因素并构建Nomogram预测模型.方法 收集2021年10月至2023年9月江西中医药大学附属医院172例肺癌术后化疗患者的临床资料.采用Piper疲乏修正量表(revised Piper fatigue scale,RPFS)进行调查,评估患者癌因性疲乏程度,Logistic多元回归模型分析影响肺癌术后化疗患者癌因性疲乏程度的危险因素并构建Nomogram预测模型,评估模型预测效能.结果 患者文化程度、肿瘤淋巴结转移分类(tumornede metastasis classification,TNM)分期、抑郁、不良反应、白细胞计数等的相关因素的RPFS评分,差异有统计学意义(P＜0.05).肺癌术后化疗患者中/重度癌因性疲乏中,高中及以上文化程度比例、TNM分期Ⅲ-Ⅳ期比例、有抑郁比例、中/重度不良反应比例、白细胞低于正常值下限比例均明显高于无/轻度癌因性疲乏的肺癌术后化疗患者,差异有统计学意义(P＜0.05).Logistic多元回归分析表明文化程度(高中以上)、TNM分期(Ⅲ-Ⅳ期)、抑郁(有)、不良反应程度(中/重度)、白细胞计数(低于正常值下限)是影响肺癌术后化疗患者癌因性疲乏程度的独立危险因素(P＜0.05).内部验证结果显示C指数为0.899(0.842～0.955),一致性较好.Nomogram模型的阈值＞0.21,Nomogram模型提供的临床净收益均高于文化程度、TNM分期、抑郁、不良反应程度、白细胞计数单一因子预测结果.结论 本研究基于肺癌术后化疗患者癌因疲乏程度的危险因素构建Nomogram模型,该模型可为临床肺癌因术后化疗患者癌性疲乏进行较好预测.
Objective To analyze the risk factors of cancer fatigue in patients with postoperative chemotherapy for lung cancer and establish a Nomogram prediction model.Methods Collect clinical data of 172 postoperative chemotherapy patients with lung cancer at the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from October 2021 to September 2023.A survey was conducted using the revised Piper fatigue scale(RPFS)to evaluate the degree of cancerous fatigue in patients.A logistic multiple regression model was used to analyze the risk factors affecting the degree of cancerous fatigue in postoperative chemotherapy patients with lung cancer,and a Nomogram prediction model was constructed to evaluate the predictive performance of the model.Results There were statistically significant differences in RPFS scores in terms of education level,tumornede metastasis classification,(TNM)staging,depression,adverse reactions,and white blood cells(P＜0.05).The proportion of high school education or above,TNM stageⅢ/Ⅳ,depression,moderate/severe adverse reactions,and the proportion of white blood cells count below the lower limit of normal in postoperative chemotherapy patients with lung cancer were significantly higher than those without/with mild cancer fatigue,and the differences were statistically significant(P＜0.05).Logistic analysis showed that education level(above high school level),TNM staging(Ⅲ/Ⅳ),depression(present),degree of adverse reactions(moderate/severe),and white blood cells(below the lower limit of normal values)were independent risk factors affecting the degree of cancer-related fatigue in postoperative chemotherapy patients with lung cancer(P＜0.05).The internal validation results show that the C-index is 0.899(0.842-0.955),with good consistency.The threshold of the Nomogram model is greater than 0.21,and the clinical net benefit provided by the Nomogram model is higher than that of educational level,TNM stage,depression,degree of adverse reactions,and a single predictor of white blood cells.Conclusion This study constructs a Nomogram model based on risk factors for cancerous fatigue in postoperative chemotherapy patients with lung cancer,which can provide a good prediction for cancerous fatigue in clinical lung cancer patients undergoing postoperative chemotherapy.
付先锋;晏燕;黄筠
江西中医药大学附属医院肿瘤科,江西南昌 330006江西中医药大学附属医院手术室,江西南昌 330006江西中医药大学附属医院综合门诊,江西南昌 330006
基础医学
肺癌化疗癌性疲乏危险因素Nomogram预测模型
Lung cancerChemotherapyCancerous fatigueRisk factorsNomogram prediction model
《中国现代医生》 2024 (026)
24-28 / 5
江西省卫生健康委员会科技计划项目(202310675)
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