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术前预测非小细胞肺癌患者隐匿性淋巴结转移:一种简单且广泛适用的模型。

Preoperative prediction of occult lymph node metastasis in patients with non-small cell lung cancer: a simple and widely applicable model.

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, No. 6, Shuangyong Road, Nanning, 530021, P. R. China.

出版信息

BMC Pulm Med. 2024 Nov 6;24(1):557. doi: 10.1186/s12890-024-03378-y.

DOI:10.1186/s12890-024-03378-y
PMID:39506749
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11542193/
Abstract

OBJECTIVE

Lymph node metastasis (LNM) is one of the most common pathways of metastasis in non-small cell lung cancer (NSCLC). Preoperative assessment of occult lymph node metastasis (OLNM) in NSCLC patients is beneficial for selecting appropriate treatment plans and improving patient prognosis.

METHOD

A total of 370 NSCLC patients were included in the study. Univariate and multivariate logistic regression analysis were used to screen potential risk factors for OLNM in preoperative NSCLC patients. And establish a nomogram for OLNM in NSCLC patients before surgery. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the established nomogram.

RESULT

Both univariate and multivariate logistic regression analyses suggested that multiple tumors, ERBB2 missense mutation, CA125 levels, CA153 levels, tumor site, tumor length, and serum ferritin are potential risk factors for OLNM in NSCLC patients. The constructed nomogram was evaluated, and the consistency index (C-index) and area under the ROC curve of the model were both 0.846. The calibration curve showed that the predicted values of the model had a high degree of fit with the actual observed values, and DCA suggested that the above indicators had good utility.

CONCLUSION

The personalized scoring prediction model constructed based on multiple tumors, ERBB2 miss mutation, CA125 levels, CA153 levels, tumor site, tumor length, and serum ferritin can screen NSCLC patients who may have OLNM.

摘要

目的

淋巴结转移(LNM)是非小细胞肺癌(NSCLC)最常见的转移途径之一。术前评估 NSCLC 患者隐匿性淋巴结转移(OLNM)有助于选择合适的治疗方案,改善患者预后。

方法

共纳入 370 例 NSCLC 患者。采用单因素和多因素逻辑回归分析筛选术前 NSCLC 患者 OLNM 的潜在危险因素,并建立术前 NSCLC 患者 OLNM 的列线图。使用受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估建立的列线图。

结果

单因素和多因素逻辑回归分析均提示,多发肿瘤、ERBB2 错义突变、CA125 水平、CA153 水平、肿瘤部位、肿瘤长度和血清铁蛋白是 NSCLC 患者 OLNM 的潜在危险因素。对构建的列线图进行评估,模型的一致性指数(C-index)和 ROC 曲线下面积均为 0.846。校准曲线表明模型的预测值与实际观测值拟合度较高,DCA 表明上述指标具有良好的实用性。

结论

基于多发肿瘤、ERBB2 错义突变、CA125 水平、CA153 水平、肿瘤部位、肿瘤长度和血清铁蛋白构建的个性化评分预测模型,可筛选出可能存在 OLNM 的 NSCLC 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/6e8415165011/12890_2024_3378_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/25d6b1f7ffa5/12890_2024_3378_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/093146e2033d/12890_2024_3378_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/70618e4470b6/12890_2024_3378_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/d141a4463441/12890_2024_3378_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/6e8415165011/12890_2024_3378_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/25d6b1f7ffa5/12890_2024_3378_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/093146e2033d/12890_2024_3378_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/70618e4470b6/12890_2024_3378_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/d141a4463441/12890_2024_3378_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/11542193/6e8415165011/12890_2024_3378_Fig5_HTML.jpg

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本文引用的文献

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Interdiscip Cardiovasc Thorac Surg. 2024 Jul 3;39(1). doi: 10.1093/icvts/ivae098.
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Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.2022 年全球癌症统计数据:全球 185 个国家和地区 36 种癌症的发病率和死亡率全球估计数。
CA Cancer J Clin. 2024 May-Jun;74(3):229-263. doi: 10.3322/caac.21834. Epub 2024 Apr 4.
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Regulation of Ferroptosis in Lung Adenocarcinoma.
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The CA125 level postoperative change rule and its prognostic significance in patients with resectable pancreatic cancer.可切除胰腺癌患者术后 CA125 水平的变化规律及其预后意义。
BMC Cancer. 2023 Sep 6;23(1):832. doi: 10.1186/s12885-023-11346-8.
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Organ-specific heterogeneity in tumor-infiltrating immune cells and cancer antigen expression in primary and autologous metastatic lung adenocarcinoma.原发性和自体转移性肺腺癌中肿瘤浸润免疫细胞和癌症抗原表达的器官特异性异质性。
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