| 探索影响下咽癌患者预后的影响因素 |
| 投稿时间：2024-10-10 修订日期：2024-11-15 点此下载全文 |
| 引用本文：程光仪,邓斯佳,王将,沈雨,王羽嫣,陈佳怡,许可,吴阳,李连涛.探索影响下咽癌患者预后的影响因素[J].医学研究杂志,2025,54(4):69-76 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.014 |
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| 基金项目:中国博士后自然科学基金面上项目(2022M722680)；江苏省自然科学基金资助项目(面上项目)(BK20231169)；江苏省高水平医院建设项目(LCZX202402) |
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| 中文摘要:目的 探讨下咽癌患者治疗前包括纤维蛋白原与白蛋白比值(fibrinogen-to-albumin ratio,FARI)、淋巴细胞与白蛋白乘积(lymphocytes × albumin, LA)等在内的炎性指标,对患者预后的预测价值,创建并内部评估基于炎性指标的列线图。方法 收集2009～2019年在徐州医科大学附属医院就诊的下咽癌患者,根据纳排条件将符合标准的患者分为训练组与验证组。通过受试者工作特征(receiver operating characteristic,ROC)曲线分析,确定最佳截断值,生存曲线采用Kaplan-Meier法进行分析。采用COX风险回归分析对影响预后的因素进行单因素和多因素分析,确定与总生存期(overall survival,OS)相关的独立预后指标后,构建预后列线图并进行内部验证。结果 回顾性分析134例下咽癌患者的相关资料,将其随机分配至训练组(n=93)与验证组(n=41)。通过单、多变量COX回归分析得到以下影响下咽癌患者生存期的因素:体重指数(body mass index, BMI)、淋巴结分期、是否行术后辅助放疗和治疗前FARI、LA、血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值。根据所得独立预后因素绘制预后列线图。训练组和验证组的列线图的C指数分别为0.81(95% CI:0.76～0.87)和0.71(95% CI:0.60～0.82)。此外,与传统的TNM分期比较,本研究所构建的列线图模型在预测患者预后方面表现出更高的准确性。结论 本研究结果证实了治疗前炎性指标对于下咽癌患者的预后意义,高FARI(>0.083)和低LA(≤77.30)与下咽癌患者的OS相关性不强。根据预后列线图可以更准确有效地预测个体预后。 |
| 中文关键词:下咽癌 炎性指标 列线图 预后 |
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| To Explore the Influencing Factors Affecting the Prognosis of Patients with Hypopharyngeal Cancer. |
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| Abstract:Objective To investigate the predictive value of inflammatory markers including:fibrinogen-to-albumin ratio (FARI) and lymphocytes × albumin (LA) product before treatment in patients with hypopharyngeal carcinoma for patient′s prognosis by creating and internally evaluating columnar graphs based on inflammatory markers. Methods Hypopharyngeal cancer patients who attended the Affiliated Hospital of Xuzhou Medical University from 2009 to 2019 were collected, and the patients who met the criteria were divided into the training group and the validation group according to the nativity conditions. The optimal cutoff value was determined by subject operating characteristic (ROC) curve analysis, and the survival curve was analyzed by Kaplan-Meier method. The factors affecting the prognosis were analyzed univariately and multivariately using COX risk regression analysis, and after determining the independent prognostic indexes related to overall survival (OS), the prognostic column line graph was constructed and internally validated. Results The relevant data of 134hypopharyngeal cancer patients were retrospectively analyzed, and they were randomly assigned to the training group (93 cases) and the validation group (41 cases). Univariate and multivariate COX regression analyses were performed to obtain the following factors affecting the survival of patients with hypopharyngeal cancer:body mass index (BMI), lymph node stage, whether or not postoperative adjuvant radiotherapy was performed, and pre-treatment FARI, LA, PLR, and NLR.A prognostic column chart was drawn based on the independent prognostic factors obtained. The C-index of the column-line diagrams for the training and validation groups were 0.81 (95% CI:0.76-0.87) and 0.71 (95% CI:0.60-0.82), respectively. In addition, our column-line diagrams demonstrated higher accuracy in predicting patient prognosis compared with conventional TNM staging. Conclusion Our findings confirm the prognostic significance of pretreatment inflammatory markers for patients with hypopharyngeal cancer, with high FARI (>0.083) and low LA (≤77.30) associated with poorer OS in patients with hypopharyngeal cancer. We can predict individual prognosis more accurately and effectively based on the prognostic column chart. |
| keywords:Hypopharyngeal cancer Inflammation indicators Nomogram Prognosis |
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