| 肺癌化疗患者营养不良的列线图预测模型构建 |
| 投稿时间：2024-10-29 修订日期：2024-11-11 点此下载全文 |
| 引用本文：宋志颖,王慧芳,陈佳,季佳丽,包胜南.肺癌化疗患者营养不良的列线图预测模型构建[J].医学研究杂志,2025,54(4):111-115, 156 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.020 |
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| 基金项目:江苏省卫生健康委员会面上项目(M2022007)；江苏省南通市卫生健康委员会科研立项课题(MB2021041)；南通大学临床医学专项项目(2022LY022)；耀动神州-药学科研能力建设基金资助项目(Z04J2023E095) |
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| 中文摘要:目的 分析肺癌化疗患者营养不良的影响因素,并依据结果构建预测列线图模型。方法 回顾性分析2022年3月～2024年4月就诊于南通市肿瘤医院的肺癌术后化疗患者100例,所有患者均已完成5个周期的化疗治疗后,统计所有患者的营养不良发生情况；根据营养评估结果分为营养良好组和营养不良组,比对患者的临床资料,通过Logistic回归分析筛选相关影响因素；构建肺癌化疗患者营养不良风险的风险预测列线图模型,绘制受试者工作特征(receivei operating characteristic,ROC)曲线以及校准曲线评估该模型的预测价值和拟合度。结果 100例受试者中共发生29例营养不良情况,其余71例患者营养状况正常；两组具有显著性差异的一般资料中,TNM为Ⅳ期(OR=2.275,95% CI:1.242～4.169)、伴消化系统不良反应(OR=2.142,95% CI:=1.133～4.050)、化疗前KPS评分低(OR=2.497,95% CI:1.349～4.621)、低白蛋白(OR=2.601,95% CI:1.370～4.937)、低血红蛋白(OR=2.697,95% CI:1.483～4.903)、低前白蛋白(OR=2.686,95% CI:1.460～4.941)均是肺癌化疗患者营养不良的相关危险因素(P＜0.05)。以上述相关危险因素为基础,构建预测肺癌化疗患者营养不良发生情况的列线图模型。ROC曲线分析显示该模型预测肺癌化疗患者发生营养不良的AUC值为0.972,95%CI为0.918～0.995。校准曲线结果显示,该列线图模型具有较好的拟合度。结论 TNM为Ⅳ期、伴有消化系统不良反应、化疗前KPS评分较低以及低水平的白蛋白、血红蛋白、前白蛋白均是肺癌化疗患者营养不良的相关危险因素,基于此构建的列线图模型同样具有较高的预测价值。 |
| 中文关键词:肺癌 化疗 营养不良 影响因素 列线图模型 |
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| Construction of Nomogram Prediction Model for Malnutrition in Patients with Lung Cancer undergoing Chemotherapy. |
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| Abstract:Objective To analyze the influencing factors of malnutrition in patients with lung cancer undergoing chemotherapy, and construct a predictive nomogram model according to the results.Methods A retrospective analysis was made on 100 patients with lung cancer who received postoperative chemotherapy in our hospital from March 2022 to April 2024. After all the patients had completed five cycles of chemotherapy, the incidence of malnutrition was counted. According to the nutritional evaluation results, the patients were divided into two groups:well-nourished group and malnourished group. The clinical data of patients were compared and the related influencing factors were screened by Logistic regression analysis. The nomogram model for risk prediction of malnutrition risk of lung cancer patients undergoing chemotherapy was constructed, and the predictive value and fitting degree of the model were evaluated by drawing the receiver operating characteristic (ROC) curve and calibration curve. Results There were 29 cases of malnutrition in 100subjects, and the other 71 patients had normal nutritional status.Among the general data with significant differences between the two groups, TNM is stage Ⅳ (OR=2.275,95%CI:1.242-4.169),Accompanied by digestive system adverse reactions (OR=2.142,95%CI:1.133-4.050),Low albumin (OR=2.601,95%CI:1.370-4.937),Low hemoglobin (OR=2.697,95%CI:1.483-4.903),Low prealbumin (OR=2.686,95%CI:1.460-4.941) is a risk factor for malnutrition in patients with lung cancer undergoing chemotherapy (P <0.05).Based on the above related risk factors, a nomogram model was established to predict the occurrence of malnutrition in patients with lung cancer undergoing chemotherapy. ROC curve analysis showed that the AUC value and 95%CI of the model for predicting malnutrition in patients with lung cancer undergoing chemotherapy were 0.972 and 0.918-0.995. The calibration curve results show that the nomogram model has a good fitting degree.Conclusion TNM is stage Ⅳ, accompanied by digestive system adverse reactions, low KPS score before chemotherapy and low levels of albumin, hemoglobin and prealbumin are all related risk factors for malnutrition in patients with lung cancer undergoing chemotherapy. The nomograph model based on this is also of high predictive value. |
| keywords:Lung cancer Chemotherapy Malnutrition Influencing factor Nomogram model |
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