Department of Respiration, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
Department of Respiration, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Clin Respir J. 2024 Aug;18(8):e13815. doi: 10.1111/crj.13815.
One major issue is the therapeutic effect following chemotherapy for non-small cell lung cancer (NSCLC). Although numerous risk factors have been identified and novel therapies have been developed, improving patient overall survival (OS) remains a crucial postoperative issue. This study aimed to develop a nomogram for accurately predicting the OS of patients with Stage III-IV NSCLC treated with chemotherapy.
The Department of Respiration at Tangdu Hospital, Air Force Medical University, prospectively collected data on 321 patients between January 2018 and December 2023. A week before treatment, the platelet-to-lymphocyte ratio (PLR), the neutrophil-to-lymphocyte ratio (NLR), and seven autoantibodies were measured using Youden's index, which was obtained using the ROC curve. The formula was used to compute the values of PLR and NLR. After using multifactor Cox regression analysis to identify risk factors, a nomogram was produced regarding the therapeutic effect following chemotherapy. The performance of the nomogram was assessed using a bootstrapped-concordance index and calibration plots.
It was determined that NLR, sex-determining region Y-box 2 (SOX2), adenosine triphosphate binding RNA deconjugase 4-5 (GBU4-5), and MAGE family member A1 (MAGEA1) were significantly associated factors that could be combined to accurately predict the therapeutic effect following chemotherapy. Utilizing these risk indicators, we were able to develop a nomogram that predicted the patients' survival at 1, 3, and 5 years. At 3 years, the area under the curve representing the expected survival probability was 0.762 (95% confidence interval 0.66-0.87). With a bootstrapped-concordance index of 0.762, the nomogram demonstrated good calibration.
Our nomogram proved to be a valuable instrument in accurately predicting the overall survival of patients.
一个主要问题是化疗治疗非小细胞肺癌（NSCLC）的疗效。尽管已经确定了许多危险因素并开发了新的疗法，但改善患者的总生存（OS）仍然是一个关键的术后问题。本研究旨在为接受化疗治疗的 III 期-IV 期 NSCLC 患者开发一种准确预测 OS 的列线图。
空军军医大学唐都医院呼吸科于 2018 年 1 月至 2023 年 12 月前瞻性收集了 321 例患者的数据。在治疗前一周，使用 Youden 指数通过 ROC 曲线测量血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和 7 种自身抗体。公式用于计算 PLR 和 NLR 的值。使用多因素 Cox 回归分析识别危险因素后，生成了一个关于化疗后疗效的列线图。使用 bootstrap 一致性指数和校准图评估列线图的性能。
确定 NLR、性别决定区 Y 框 2（SOX2）、三磷酸腺苷结合 RNA 去连接酶 4-5（GBU4-5）和 MAGE 家族成员 A1（MAGEA1）是与化疗后疗效显著相关的因素，可以结合起来准确预测。利用这些风险指标，我们能够开发出一种列线图，可以预测患者在 1、3 和 5 年内的生存情况。在 3 年时，代表预期生存概率的曲线下面积为 0.762（95%置信区间为 0.66-0.87）。Bootstrap 一致性指数为 0.762，表明该列线图具有良好的校准度。
我们的列线图证明是一种准确预测患者总体生存的有价值的工具。
