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肺癌患者完全植入式静脉输液港相关长期并发症的预测模型

Predictive model for totally implanted venous access ports‑related long‑term complications in patients with lung cancer.

作者信息

Jia Jian, Fan Xutong, Zhang Wenhong, Xu Zhiyang, Wu Mian, Zhan Yiyang, Fan Boqiang

机构信息

Department of General Practice, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.

School of Business, Nanjing University, Nanjing, Jiangsu 210093, P.R. China.

出版信息

Oncol Lett. 2024 May 15;28(1):326. doi: 10.3892/ol.2024.14459. eCollection 2024 Jul.

Abstract

Totally implanted venous access ports (TIVAPs), which are typically used in oncological chemotherapy and parenteral nutritional support, are convenient and safe, and thus offer patients a higher quality of life. However, insertion or removal of the device requires a minor surgical operation. Long-term complications (>30 days post insertion), such as catheter migration, catheter-related thrombosis and infection, are major reasons for TIVAP removal and are associated with a number of factors such as body mass index and hemoglobin count. Since management of complications is typically time-consuming and costly, a predictive model of such events may be of great value. Therefore, in the present study, a predictive model for long-term complications following TIVAP implantation in patients with lung cancer was developed. After excluding patients with a large amount of missing data, 902 patients admitted to The First Affiliated Hospital with Nanjing Medical University (Nanjing, China) were ultimately included in the present study. Of the included patients, 28 had complications, indicating an incidence rate of 3.1%. Patients were randomly divided into training and test cohorts (7:3), and three machine learning-based anomaly detection algorithms, namely, the Isolation Forest, one-class Support Vector Machines (one-class SVM) and Local Outlier Factor, were used to construct a model. The performance of the model was initially evaluated by the Matthew's correlation coefficient (MCC), area under curve (AUC) and accuracy. The one-class SVM model demonstrated the highest performance in classifying the risk of complications associated with the use of the intracavitary electrocardiogram method for TIVAP implantation in patients with lung cancer (MCC, 0.078; AUC, 0.62; accuracy, 66.0%). In conclusion, the predictive model developed in the present study may be used to improve the early detection of TIVAP-related complications in patients with lung cancer, which could lead to the conservation of medical resources and the promotion of medical advances.

摘要

完全植入式静脉通路端口(TIVAPs)通常用于肿瘤化疗和肠外营养支持,既方便又安全,因此能为患者提供更高的生活质量。然而,该装置的插入或移除需要进行小手术。长期并发症(插入后>30天),如导管移位、导管相关血栓形成和感染,是移除TIVAP的主要原因,并且与一些因素有关,如体重指数和血红蛋白计数。由于并发症的处理通常既耗时又昂贵,因此此类事件的预测模型可能具有很大价值。因此,在本研究中,开发了一种预测肺癌患者TIVAP植入术后长期并发症的模型。在排除大量数据缺失的患者后,最终纳入了南京医科大学第一附属医院(中国南京)收治的902例患者。在纳入的患者中,28例出现并发症,发病率为3.1%。患者被随机分为训练组和测试组(7:3),并使用三种基于机器学习的异常检测算法,即孤立森林算法、单类支持向量机(单类SVM)和局部离群因子算法来构建模型。该模型的性能最初通过马修斯相关系数(MCC)、曲线下面积(AUC)和准确率进行评估。单类SVM模型在对肺癌患者使用腔内心电图法植入TIVAP相关并发症风险进行分类方面表现出最高性能(MCC,0.078;AUC,0.62;准确率,66.0%)。总之,本研究中开发的预测模型可用于改善肺癌患者TIVAP相关并发症的早期检测,这可能有助于节约医疗资源并推动医学进步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89d2/11130750/d879c5d94575/ol-28-01-14459-g00.jpg

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