Construction of Nomogram Model for Stage Ⅲ-Ⅳ Non-Small Cell Lung Cancer Patients Based on Serological Indicators
Objective To explore the predictive value of serological indicators and clinical characteristics on overall survival(OS)in stage Ⅲ-Ⅳ non-small cell lung cancer(NSCLC)patients and to construct a nomogram model for predicting the prognosis of stageⅢ-Ⅳ NSCLC patients.Methods A retrospective analysis was conducted,and clinical data of 272stage Ⅲ-Ⅳ NSCLC patients admit-ted to Dongzhimen Hospital,Beijing University of Chinese Medicine from January 2012 to December 2022 were collected.The patients were randomly divided into training group(n=163)and validation group(n=109)at a ratio of 6:4.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal cut-off values for continuous variables,which were then converted into binary variables.Univariate COX regression analysis was performed on the clinical data of the training group to preliminarily screen out relevant variables with statistical significance(P＜0.05).Further,the akaike information criterion(AIC)was used to screen the relevant varia-bles,and the model with the smallest AIC value was selected to construct the nomogram.Results Finally,four variables including neu-trophil to monocyte ratio,D-dimer,gamma-glutamyl transferase,and surgical history were used to construct nomogram for predicting 1-year,3-year and 5-year OS in stage Ⅲ-Ⅳ NSCLC patients.The C-index was 0.789(95％CI:0.757-0.821)for the training group and 0.692(95％CI:0.592-0.792)for the validation group.The area under the ROC curve for predicting 1-year,3-year,and 5-year survival rates was all＞0.6,indicating good discriminative ability of the model.Decision curves analysis for both groups showed that the nomogram had higher net benefit compared to the TNM staging model.X-tile software was used to stratify patients by risk,and Kaplan-Meier survival curves showed good discriminatory ability of the model for high-and low-risk patients.Conclusion The nomogram constructed in this study has good predictive value for the prognosis of stage Ⅲ-Ⅳ NSCLC patients and can serve as a supplement to TNM staging,helping clinicians to individualize the assessment of patient survival.
NETL
NSTL
万方数据
