中医肿瘤学杂志2025，Vol.7Issue(6)：28-40,13.DOI:10.19811/j.cnki.ISSN2096-6628.2025.11.004
整合中医脾虚因素的晚期肝癌预后模型构建:一项回顾性队列研究
Construction of A Prognostic Model for Advanced Liver Cancer Integrating the Spleen Deficiency Factor of Traditional Chinese Medicine:A Retrospective Cohort Study
摘要
Abstract
Objective Current prognostic assessments for advanced liver cancer lack elements of traditional Chinese medicine(TCM)syndromes,particularly overlooking the impact of"deficiency patterns"on quality of life and treatment tolerance.This study aims to integrate prognostic predictors of both Western medicine and TCM to construct a simple prognostic prediction model for advanced liver cancer and to establish standards for deficiency pattern assessment,thereby guiding individualized clinical decision-making.Methods A retrospective cohort analysis was conducted on 122 patients with advanced liver cancer to explore the relationship between the degree of spleen deficiency and prognosis.Univariate and multivariate Cox regression analyses were used to develop an integrated Western medicine and TCM prognostic model for advanced liver cancer.The model's performance was evaluated using receiver operating characteristic(ROC),calibration curves,and decision curve analysis(DCA).Results The degree of spleen deficiency was significantly associated with poor prognosis in advanced liver cancer.Multivariate Cox analysis identified Child-Pugh grade,spleen deficiency grade,prealbumin level,and performance status(PS)score as independent predictors of overall survival(OS).The prognostic model constructed based on these variables achieved the area under the ROC curve(AUC)of 0.847,0.937,and 0.967 for 6-month,12-month,and 24-month survival,respectively.The calibration curves closely aligned with the ideal diagonal,and DCA demonstrated clinical net benefit,with performance superior to that of the Child-Pugh grade or PS score alone.After 1 000 Bootstrap samplings for internal validation,the model shrinkage coefficient was 1.136,indicating that the model had good stability.Conclusion Spleen deficiency is an important factor influencing the prognosis of advanced liver cancer.The integrated Western medicine and TCM nomogram developed in this study accurately predicts patients'survival rates at 6,12,and 24 months.The established deficiency pattern evaluation criteria can provide a basis for selecting strategies of"reinforcing healthy qi"and"eliminating pathogens"in combined Western medicine and TCM treatment.关键词
原发性肝癌/中医/脾虚/列线图/预后模型Key words
primary liver cancer/traditional Chinese medicine/spleen deficiency/nomogram/prognostic model分类
医药卫生引用本文复制引用
黄佳兴,罗慧燕,张晓莹,蔡玉荣,潘华峰,王雄文..整合中医脾虚因素的晚期肝癌预后模型构建:一项回顾性队列研究[J].中医肿瘤学杂志,2025,7(6):28-40,13.基金项目
重庆市科卫联合中医药科研项目重大项目(编号:2024ZYDB001) （编号:2024ZYDB001）
国家自然科学基金面上项目(编号:82274605) （编号:82274605）
国家自然科学基金面上项目(编号:82474591) （编号:82474591）
深圳市基础研究专项自然科学基金面上项目(编号:JCYJ20240813160605008). （编号:JCYJ20240813160605008）
