实用医学杂志2025，Vol.41Issue(15)：2349-2354,6.DOI:10.3969/j.issn.1006-5725.2025.15.009
系统性免疫炎症指数预测前列腺癌盆腔淋巴结转移列线图模型的建立
Establishment of a nomogram model for predicting pelvic lymph node metastasis in prostate cancer based on systemic immune-infiltration inflammation index
摘要
Abstract
Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.关键词
前列腺癌/盆腔淋巴结转移/全身炎症标志物/列线图模型Key words
prostate cancer/pelvic lymph node metastasis/systemic inflammatory markers/nomo-gram model分类
医药卫生引用本文复制引用
刘俊志,邱磊,徐坤,刘建炜,胡德华,朱华,沈城,陆明,陈建刚..系统性免疫炎症指数预测前列腺癌盆腔淋巴结转移列线图模型的建立[J].实用医学杂志,2025,41(15):2349-2354,6.基金项目
湖南省重点领域研发计划(国际与区域合作)(编号:2021WK2003) （国际与区域合作）
南通市卫生健康委员会科研课题专项(编号:MS2024032) （编号:MS2024032）
南通大学临床医学专项科研基金项目(编号:2024LY006,2024LQ019) （编号:2024LY006,2024LQ019）
