一种用于预测固体癌症患者静脉血栓栓塞的风险的诺米克图
Siyu Chen1, Wei Sun1, Min Dan1
1Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
Journal of thrombosis and thrombolysis
|July 18, 2023
概括
这项研究开发了一种名谱,用于预测癌症患者的静脉血栓栓塞 (VTE) 风险. 与Khorana得分相比,该名录显示出更高的预测准确性,有助于识别针对性血栓预防治疗的高风险个体.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 医学统计 医学统计
背景情况:
- 癌症患者面临静脉血栓塞栓症 (VTE) 的风险增加,这种情况与预后较差有关.
- 准确预测VTE风险对于及时干预和改善瘤学患者结果至关重要.
- 现有的风险分层工具可能在准确识别各种癌症群体中的VTE风险方面存在局限性.
研究的目的:
- 开发和验证静脉血栓塞栓症 (VTE) 风险的预测性名录,特别是在有固体瘤的患者中.
- 为了确定与VTE发展相关的独立风险因素,在这个患者队列.
- 为了比较开发的nomogram与已建立的Khorana得分的性能.
主要方法:
- 在2017年1月至2021年5月期间诊断出791名实体瘤患者的回顾性分析.
- 应用单变量物流分析和多变量物流回归来识别独立的风险因素.
- 开发基于回归系数的名图;使用校准图和ROC曲线评估性能,与Khorana评分进行比较.
主要成果:
- 鉴定了VTE的独立风险因素:晚年 (≥60岁),瘤阶段III-IV,血小板分布宽度低 (PDW ≤12.6%),白蛋白低 (≤38.8 g/L),乳酸脱酶升高 (LDH ≥198 U/L),高D-二次数 (≥1.72 μg/mL),低血红蛋白 (≤100 g/dL) 或使用红色素生成刺激剂,以及特定的癌症类型.
- 开发的诺米图实现了0.852的高一致性指数 (C指数) (95% CI 0.823-0.880).
- 诺米图显著优于科拉纳得分,该得分的C指数为0.681 (95%CI为0.639-0.723).
结论:
- 开发的诺米图是预测固体瘤癌症患者静脉瘤风险的强大工具.
- 它的卓越性能表明,它有可能改善VTE风险分层和血栓预防的临床决策.
- 建议进行外部验证,以确认名图的概括性和在不同患者群体中的临床实用性.
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