Chen Yi, Liu Xingyu, Yu Jun, Li Jianshui, Li Jingdong, Yi Pengsheng, Wu Bin, Zhang Guangnian, Deng Dawei, Li Yong, Yan Shu, Ma Lin, Lan Chuan
Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China.
Front Oncol. 2025 May 21;15:1521616. doi: 10.3389/fonc.2025.1521616. eCollection 2025.
Currently, there is no validated model for predicting the occurrence and prognosis of lung metastases (LM) in patients with pancreatic ductal adenocarcinoma (PDAC). We aimed to construct a nomogram for risk prediction and a prognostic model to guide clinical practice.
In total, 10,813 patients were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 and divided into training and internal validation cohorts at a ratio of 7:3. Following nomogram construction, data of patients diagnosed with PDAC were retrospectively collected for external validation.
Using multivariate logistic regression analysis, larger tumour size, primary tumour site in the body or tail of the pancreas, bone metastasis, and liver metastasis were associated with LM. Furthermore, through multivariate Cox analysis, we found that LM was associated with a poor prognosis in patients with PDAC. Patients who underwent surgery or chemotherapy had better prognoses.
The two nomograms showed excellent performance in the training and internal validation cohorts and a favourable performance in the external validation. The prognostic nomogram divided the patients into high- and low-risk groups based on mortality. The LM risk and prognostic prediction model in PDAC showed high accuracy and reliable clinical application.
目前，尚无经过验证的模型可用于预测胰腺导管腺癌（PDAC）患者肺转移（LM）的发生及预后。我们旨在构建一个用于风险预测的列线图和一个预后模型，以指导临床实践。
2010年至2015年期间，从监测、流行病学和最终结果（SEER）数据库中总共纳入了10813例患者，并按照7:3的比例分为训练队列和内部验证队列。在构建列线图之后，回顾性收集诊断为PDAC的患者数据进行外部验证。
使用多因素逻辑回归分析，肿瘤体积较大、胰腺体部或尾部的原发肿瘤部位、骨转移和肝转移与肺转移相关。此外，通过多因素Cox分析，我们发现肺转移与胰腺导管腺癌患者的预后不良相关。接受手术或化疗的患者预后较好。
这两个列线图在训练队列和内部验证队列中表现出色，在外部验证中表现良好。预后列线图根据死亡率将患者分为高风险和低风险组。胰腺导管腺癌的肺转移风险和预后预测模型显示出高准确性和可靠的临床应用价值。
