Nieder Carsten, Andratschke Nicolaus H, Grosu Anca L
Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway.
Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
Front Oncol. 2023 Apr 11;13:1156161. doi: 10.3389/fonc.2023.1156161. eCollection 2023.
The validated LabBM score (laboratory parameters in patients with brain metastases) represents a widely applicable survival prediction model, which incorporates 5 blood test results (serum lactate dehydrogenase (LDH), C-reactive protein (CRP), albumin, platelets and hemoglobin). All tests are classified as normal or abnormal, without accounting for the wide range of abnormality observed in practice. We tested the hypothesis that improved stratification might be possible, if more granular test results are employed.
Retrospective analysis of 198 patients managed with primary whole-brain radiotherapy in one of the institutions who validated the original LabBM score.
For two blood tests (albumin, CRP), discrimination was best for the original dichotomized version (normal/abnormal). For two others (LDH, hemoglobin), a three-tiered classification was best. The number of patients with low platelet count was not large enough for detailed analyses. A modified LabBM score was developed, which separates the intermediate of originally 3 prognostic groups into 2 statistically significantly different strata, resulting in a 4-tiered score.
This initial proof-of-principle study suggests that granular blood test results might contribute to further improvement of the score, or alternatively development of a nomogram, if additional large-scale studies confirm the encouraging results of the present analysis.
经过验证的LabBM评分（脑转移患者的实验室参数）是一种广泛适用的生存预测模型，它纳入了5项血液检测结果（血清乳酸脱氢酶（LDH）、C反应蛋白（CRP）、白蛋白、血小板和血红蛋白）。所有检测结果均分为正常或异常，未考虑实际中观察到的广泛异常范围。我们检验了这样一个假设，即如果采用更细化的检测结果，可能会实现更好的分层。
对其中一家验证了原始LabBM评分的机构中接受原发性全脑放疗的198例患者进行回顾性分析。
对于两项血液检测（白蛋白、CRP），原始的二分法版本（正常/异常）的区分效果最佳。对于另外两项检测（LDH、血红蛋白），三级分类最佳。血小板计数低的患者数量不足以进行详细分析。开发了一种改良的LabBM评分，将原来3个预后组中的中间组分为2个在统计学上有显著差异的亚组，从而形成了一个四级评分。
这项初步的原理验证研究表明，如果额外的大规模研究证实了本分析令人鼓舞的结果，那么细化的血液检测结果可能有助于进一步改进该评分，或者有助于开发一种列线图。
