Qiao Han, Feng Yan, Han Xiaolei, Tang Huaping
Department of Respiratory Medicine, Qingdao University, Qingdao, China.
Department of Health Office, Qingdao Municipal Hospital, Qingdao, China.
Front Oncol. 2024 Jun 20;14:1393684. doi: 10.3389/fonc.2024.1393684. eCollection 2024.
This study focuses on determining the prognostic and predictive value of the comprehensive prognostic nutrition index (FIDA) in individuals undergoing treatment for Non-Small-Cell Lung Carcinoma (NSCLC).
This retrospective analysis encompassed 474 of NSCLC patients treated from January 2010 through December 2019. Employing the Lasso-COX regression approach, eight blood parameters were identified as significant prognostic indicators. These parameters contributed to the formulation of the comprehensive prognostic nutrition index FIDA. Utilizing X-tile software, the patient cohort was categorized into either a high or low FIDA group based on an established optimal threshold. The cohort was then randomly segmented into a training set and a validation set using SPSS software. Subsequent steps involved conducting univariate and multivariate regression analyze to develop a prognostic nomogram. The effectiveness of this nomogram was evaluated by calculating the AUC.
Analysis of survival curves for both the training and validation sets revealed a poorer prognosis in the high FIDA group compared to the low FIDA group. This trend persisted across various subgroups, including gender, age, and smoking history, with a statistical significance (p<0.05). Time-dependent ROC and diagnostic ROC analyses affirmed that FIDA serves as an effective diagnostic and prognostic marker in NSCLC. Moreover, Cox regression multivariate analysis established FIDA as an independent prognostic factor for NSCLC. The prognostic nomogram, integrating FIDA and clinical data, demonstrated substantial prognostic utility and outperformed the traditional TNM staging systemin predicting overall survival (OS).
FIDA emerges as a dependable predictor of outcomes for patients with NSCLC. It offers a practical, cost-effective tool for prognostication in regular clinical applications.
本研究聚焦于确定综合预后营养指数(FIDA)在接受非小细胞肺癌(NSCLC)治疗的个体中的预后及预测价值。
这项回顾性分析纳入了2010年1月至2019年12月期间接受治疗的474例NSCLC患者。采用套索-COX回归方法,确定了八个血液参数为显著的预后指标。这些参数有助于制定综合预后营养指数FIDA。利用X-tile软件,根据既定的最佳阈值将患者队列分为高FIDA组或低FIDA组。然后使用SPSS软件将该队列随机分为训练集和验证集。后续步骤包括进行单变量和多变量回归分析以开发预后列线图。通过计算AUC评估该列线图的有效性。
训练集和验证集的生存曲线分析显示,高FIDA组的预后比低FIDA组差。这种趋势在包括性别、年龄和吸烟史在内的各个亚组中均持续存在,具有统计学意义(p<0.05)。时间依赖性ROC和诊断性ROC分析证实,FIDA是NSCLC中一种有效的诊断和预后标志物。此外,Cox回归多变量分析确定FIDA为NSCLC的独立预后因素。整合FIDA和临床数据的预后列线图在预测总生存期(OS)方面显示出显著的预后效用,且优于传统的TNM分期系统。
FIDA成为NSCLC患者预后的可靠预测指标。它为常规临床应用中的预后评估提供了一种实用、经济高效的工具。