非小细胞肺癌中术后肺部感染的危险因素:基于回归的诺莫格拉姆预测模型
Chao Zhang1, Yongxing Fu2, Qiangjun Chen3
1Department of Pediatrics, Qilu Hospital of Shandong University Jinan 250012, Shandong, China.
American journal of cancer research
|December 11, 2024
概括
这项研究确定了肺癌 (LC) 患者术后肺部感染 (PPI) 的关键风险因素,并开发了一种用于准确预测PPI风险的诺莫格拉姆模型,以帮助个性化干预.
科学领域:
- 在瘤学瘤学.
- 肺部医学 肺部医学
- 医疗信息学 医疗信息学
背景情况:
- 手术后肺部感染 (PPI) 是肺癌 (LC) 患者进行激进手术的重要并发症.
- 准确预测PPI风险对于有效的术后管理和患者的结果至关重要.
研究的目的:
- 在接受激进手术的LC患者中确定PPI的关键风险因素.
- 开发和验证一个多参数名录模型,以提高PPI风险预测准确度.
- 引导个性化干预措施,以减少该患者群中的PPI发病率.
主要方法:
- 从2020年3月到2023年5月的1,084名LC患者的回顾性分析.
- 机器学习技术 (LASSO,SVM,XGBoost) 用于选关键的PPI风险因素.
- 使用校准曲线和决策曲线分析开发和内部验证名ogram预测模型.
主要成果:
- 确定了与PPI相关的13个重要因素,包括瘤阶段,糖尿病,COPD,手术持续时间,通风持续时间,年龄和炎症标志物 (CRP,PCT,HMGB1,IL-6,NLR,PLR,SII).
- 诺莫格拉姆模型实现了高预测精度 (C指数=0.935) 具有强大的校准和临床效用.
- 该模型有效地区分了样本病例中的感染风险,预测感染患者的概率为63%,未感染患者的概率为32%.
结论:
- 多参数的诺米图模型提供了一个可靠的工具,用于预测肺癌患者的PPI风险.
- 该模型支持临床决策,并增强术后管理策略.
- 个性化干预可以通过这种预测模型来指导,以改善患者的治疗结果.
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