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基于炎症因子C反应蛋白和纤维蛋白原的列线图预测非小细胞肺癌切除患者的预后价值

A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer.

作者信息

Zeng Qiuyao, Xue Ning, Dai Danian, Xing Shan, He Xia, Li Shibing, Du Yi, Huang Chumei, Li Linfang, Liu Wanli

机构信息

State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China.

State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China.

出版信息

J Cancer. 2017 Feb 25;8(5):744-753. doi: 10.7150/jca.17423. eCollection 2017.

Abstract

This study aimed to develop an effective nomogram for predicting survival in surgically treated non-small cell lung cancer patients. We retrospectively evaluated 856 NSCLC in this study. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (C-index). On multivariate analysis of the 856 cohort, independent factors for survival were CRP, fibrinogen, tumor status, nodal status, distant metastasis and clinical stage, which were entered into the nomogram. The C-index of the established nomogram 0.720 (95% CI: 0.671-0.769) was higher than that of the seventh edition TNM staging system 0.689 (95% CI: 0.668-0.709) for predicting OS (P < 0.05). Compared with patients with low CRP levels (< 8.6 g/L) and low fibrinogen levels (< 3.7 g/L), patients with high CRP and fibrinogen levels had shorter OS. Subgroup analyses revealed that the nomogram was a favorable prognostic parameter in stage I-IV NSCLC (P < 0.05). A nomogram integrating CRP and fibrinogen, which could be convenient and feasible to obtain from the serum preoperatively, may assist in risk stratification for individual patient with resected NSCLC.

摘要

本研究旨在开发一种有效的列线图,用于预测接受手术治疗的非小细胞肺癌患者的生存率。我们在本研究中回顾性评估了856例非小细胞肺癌患者。进行Cox回归分析以确定用于开发预测总生存期(OS)列线图的显著预后因素。用一致性指数(C指数)评估判别能力。在对856例队列进行多变量分析时,生存的独立因素为CRP、纤维蛋白原、肿瘤状态、淋巴结状态、远处转移和临床分期,这些因素被纳入列线图。所建立列线图的C指数为0.720(95%CI:0.671-0.769),高于第七版TNM分期系统预测OS时的C指数0.689(95%CI:0.668-0.709)(P<0.05)。与CRP水平低(<8.6 g/L)和纤维蛋白原水平低(<3.7 g/L)的患者相比,CRP和纤维蛋白原水平高的患者OS较短。亚组分析显示,列线图在I-IV期非小细胞肺癌中是一个良好的预后参数(P<0.05)。一种整合CRP和纤维蛋白原的列线图,术前从血清中获取方便可行,可能有助于对接受手术的非小细胞肺癌患者进行个体风险分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6b1/5381162/5e564044b130/jcav08p0744g001.jpg

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