评估在现实环境中识别化疗相关血液毒性的方法
Peng Wang1,2, Kelli O'Connell1, Jenna Bhimani1
1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
International journal of cancer
|November 28, 2025
概括
确定化疗相关的血液毒性,如贫血,中性质衰竭和血小板衰竭至关重要. 将实验室数据 (等级-2+) 与国际疾病分类 (ICD) 代码相结合,与单独使用任何来源相比,为研究提供了更好的准确性.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 临床研究方法论 临床研究方法论
背景情况:
- 化疗通常会导致血液毒性,影响治疗和患者的治疗结果.
- 使用实验室结果和国际疾病分类 (ICD) 代码在现实环境中准确识别这些毒性对研究至关重要,但最佳方法尚不清楚.
研究的目的:
- 评估实验室数据和ICD代码的性能,单独和组合,用于确定乳腺癌患者的化疗相关的血液毒性 (贫血,中性质减退,血小细胞减退).
主要方法:
- 对854名患有I-IIIA阶段乳腺癌,接受辅助化疗的女性进行了回顾性分析.
- 使用实验室值 (不良事件等级1-3的常用术语标准),ICD代码和组合方法来定义毒性.
- 将定义与图表审查进行比较,以评估灵敏度,特异性和正预测值 (PPV).
主要成果:
- 级别-1+的实验室数据显示高灵敏度但低特异性和PPV.
- 3级以上的实验室数据显示灵敏度低,但特异性高,PPV.
- 国际疾病分类 (ICD) 代码和2级+实验室数据显示出平衡的性能.
- 将2级+实验室数据与ICD代码结合起来,提高了灵敏度,但没有显著的特异性或PPV损失.
结论:
- 国际疾病分类 (ICD) 代码和2级+实验室数据为定义血液毒性提供中等至良好的性能.
- 实验室数据 (等级-2+) 和ICD代码的组合为识别与化疗相关的血液毒性提供了优越的性能,而不是单独使用任何一种方法.
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