首页|直径≤3cm肺腺癌胸腔镜术后淋巴结转移的预测模型构建

直径≤3cm肺腺癌胸腔镜术后淋巴结转移的预测模型构建

扫码查看
目的 基于患者临床病理特征的列线图(nomogram)来预测肺腺癌患者胸腔镜手术后淋巴结转移概率.方法 回顾性分析2018年6月—2021年5月四川省内江市第一人民医院胸外科收治肺腺癌患者的临床资料.将患者随机分为训练集及验证集.先行单因素logistic回归分析筛选可能影响肺腺癌淋巴结转移的变量,再行多因素logistic回归分析构建临床预测模型.列线图可视化展示模型,采用受试者工作特征(receiver operating characteristic,ROC)曲线及校准曲线、临床决策曲线评价模型的校准度、实用性.结果 纳入249例患者,其中男117例,年龄(53.15±13.95)岁;女132例,年龄(47.36±13.10)岁.训练集180例、验证集69例.单因素logistic回归分析显示,6个临床病理特征与肺腺癌淋巴结转移显著相关.训练集ROC曲线下面积为0.863,提示有能力区分淋巴结转移情况,同时在验证集中得以证实(ROC曲线下面积为0.847).列线图与临床决策曲线在后续分析中同样表现良好,证明了其潜在临床价值.结论 本研究提供了以临床特征及分子病理学相结合的列线图,可用于预测直径≤3 cm肺腺癌患者胸腔镜术后淋巴结转移风险.
A predictive model of lymph node metastasis after thoracoscopic surgery for lung adenocarcinoma with a diameter ≤3 cm
Objective To predict the probability of lymph node metastasis after thoracoscopic surgery in patients with lung adenocarcinoma based on nomogram.Methods We analyzed the clinical data of the patients with lung adenocarcinoma treated in the department of thoracic surgery of our hospital from June 2018 to May 2021.The patients were randomly divided into a training group and a validation group.The variables that may affect the lymph node metastasis of lung adenocarcinoma were screened out by univariate logistic regression,and then the clinical prediction model was constructed by multivariate logistic regression.The nomogram was used to show the model visually,the receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve to evaluate the calibration degree and practicability of the model.Results Finally 249 patients were collected,including 117 males aged 53.15±13.95 years and 132 females aged 47.36±13.10 years.There were 180 patients in the training group,and 69 patients in the validation group.There was a significant correlation between the 6 clinicopathological characteristics and lymph node metastasis of lung adenocarcinoma in the univariate logistic regression.The area under the ROC curve in the training group was 0.863,suggesting the ability to distinguish lymph node metastasis,which was confirmed in the validation group(area under the ROC curve was 0.847).The nomogram and clinical decision curve also performed well in the follow-up analysis,which proved its potential clinical value.Conclusion This study provides a nomogram combined with clinicopathological characteristics,which can be used to predict the risk of lymph node metastasis in patients with lung adenocarcinoma with a diameter≤ 3 cm.

Nomogramlung adenocarcinomalymph node metastasis

杨彦辉、李季、王毅、李晓亮、罗雷、成欣、谢晓阳

展开 >

四川省内江市第一人民医院重庆医科大学附属内江医院胸外科(四川内江 641000)

列线图 肺腺癌 淋巴结转移

四川省卫生健康委员会科研课题四川省自然科学基金科研课题

20PJ28920PJ289

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(1)
  • 23