个体化预测非小细胞肺癌患者化疗期间肺部感染风险Nomogram模型的建立与验证
作者:
作者单位:

1.泰州市人民医院呼吸与危重症医学科, 江苏 泰州 225300;2.泰州市人民医院护理部, 江苏 泰州 225300

作者简介:

通讯作者:

冯国琴  E-mail: fgq.tz@163.com

中图分类号:

+2  R734.2]]>

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Construction and validation of Nomogram model for individualized prediction of risk of pulmonary infection in patients with non-small cell lung cancer during chemotherapy
Author:
Affiliation:

1.Department of Respiratory and Critical Care Medicine, Taizhou People's Hospital, Taizhou 225300, China;2.Department of Nursing, Taizhou People's Hospital, Taizhou 225300, China

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    摘要:

    目的 构建个体化预测非小细胞肺癌(NSCLC)患者化学治疗(化疗)期间发生肺部感染的风险Nomogram模型,并对模型的预测效能进行验证。 方法 选取2018年2月-2021年1月在某院进行治疗的218例NSCLC患者作为研究对象,根据化疗后是否发生肺部感染将其分为肺部感染组(n=56)和非肺部感染组(n=162),采用LASSO和logistic回归分析筛选NSCLC患者化疗期间发生肺部感染的独立危险因素,并构建Nomogram预测模型。 结果 纳入218例NSCLC患者,56例化疗期间发生肺部感,感染发病率为25.69%。LASSO和logistic回归分析结果显示:年龄≥ 60岁、糖尿病、联合化疗药物、化疗周期>2次、化疗后清蛋白含量 < 30 g/L、化疗前KPS评分 < 80分是NSCLC患者化疗期间发生肺部感染的独立预测因素(均P < 0.05)。基于6项独立预测因素建立预测NSCLC患者化疗期间发生肺部感染的风险Nomogram模型,验证结果显示,训练集和验证集的C-index分别为0.819(95%CI:0.788~0.850)、0.802(95%CI:0.778~0.829),两集校准曲线走向与对角线(理想曲线)较为贴近,受试者工作特征曲线下面积分别为0.807(95%CI:0.775~0.839)、0.797(95%CI:0.773~0.821),决策曲线显示阈值概率在1%~90%时,有较高的净获益值。 结论 基于NSCLC患者化疗期间发生肺部感染独立预测因素建立的Nomogram模型,具有较好的预测效能,有助于临床及早筛查高风险患者和进一步改进治疗计划。

    Abstract:

    Objective To construct a Nomogram model for individualized prediction of risk of pulmonary infection (PI) in patients with non-small cell lung cancer (NSCLC) during chemotherapy period, and validate the prediction efficiency of the model. Methods 218 patients with NSCLC who were treated in a hospital from February 2018 to January 2021 were selected as the research objects, according to whether they had PI after chemotherapy, they were divided into PI group (n=56) and pulmonary non-infection group (n=162), LASSO and logistic regression analysis were used to screen the independent risk factors for PI in NSCLC patients during chemotherapy, and a Nomogram prediction model was constructed. Results 218 NSCLC patients were included in study, 56 patients had PI during chemotherapy, incidence of PI was 25.69%. LASSO and logistic regression analysis showed that age ≥ 60 years old, diabetes mellitus, combined chemotherapy drugs, chemotherapy cycle >2 times, albumin content after chemotherapy < 30 g/L, KPS score < 80 points before chemotherapy were independent predictors of PI in NSCLC patients during chemotherapy (all P < 0.05). Based on 6 independent predictors, the Nomogram model was constructed to predict the risk of PI in NSCLC patients during chemotherapy. Validation result showed that the C -index of the training set and validation set were 0.819 (95%CI: 0.788-0.850) and 0.802 (95%CI: 0.778-0.829) respectively. The calibration curve trend of two sets was relatively close to the diagonal (ideal curve), the area under the ROC curve (AUC) were 0.807 (95%CI: 0.775-0.839) and 0.797 (95%CI: 0.773-0.821) respectively. When the decision curve showed that the threshold probability was 1%-90%, there was a relatively high net profit value. Conclusion Nomogram model based on independent predictors of PI in NSCLC patients du-ring chemotherapy has good prediction efficiency, which is helpful to screen high-risk patients as early as possible and improvement of treatment plans.

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引用本文

张俐丽,冯国琴.个体化预测非小细胞肺癌患者化疗期间肺部感染风险Nomogram模型的建立与验证[J]. 中国感染控制杂志,2022,(2):171-179. DOI:10.12138/j. issn.1671-9638.20221928.
Li-li ZHANG, Guo-qin FENG. Construction and validation of Nomogram model for individualized prediction of risk of pulmonary infection in patients with non-small cell lung cancer during chemotherapy[J]. Chin J Infect Control, 2022,(2):171-179. DOI:10.12138/j. issn.1671-9638.20221928.

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  • 收稿日期:2021-09-22
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  • 在线发布日期: 2024-04-28
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