摘要
目的基于最小绝对收缩和选择算子(LASSO)回归构建非小细胞肺癌患者PONV预测列线图并验证其预测效果。方法收集2021年4月至2022年2月郑州大学第一附属医院胸外科接受肺叶切除术成年非小细胞肺癌患者临床数据。选取符合纳入标准的738例患者,根据随机数表,患者按7∶3的比例分为训练队列(517例)和验证队列(221例)。在对训练队列进行LASSO回归分析后,筛选PONV的独立危险因素,建立列线图模型。使用受试者工作特征曲线下面积(AUC)、校准曲线、决策曲线分析(DCA)来评估该模型的预测效率、准确性和临床实用性。结果通过LASSO回归筛选非小细胞肺癌患者PONV 3个独立的危险因素:性别、体重及单核细胞计数,并且构建PONV风险预测列线图,该模型训练集和内部验证集的ROC曲线下面积分别为0.687[95%可信区间(CI):0.641~0.714],0.683(95%CI:0.656~0.725);校准图显示预测观测值与实际观测值之间具有良好一致性;DCA的结果显示阈值概率8%~25%时,该模型可以最大临床获益。结论本研究构建并验证非小细胞肺癌患者PONV列线图的预测效能和临床实用性。
Objective To construct a predictive nomogram for postoperative nausea and vomiting(PONV)in non-small cell lung cancer(NSCLC)patients based on least absolute shrinkage and selection operator(LASSO)regression and validate its predictive effect.MethodsRetrospective clinical data of adult NSCLC patients who underwent pulmonary lobectomy surgery at the First Affiliated Hospital of Zhengzhou University from April 2021 to February 2022 were collected.A total of 738 eligible patients were selected and divided into a training cohort(n=517)and a validation cohort(n=221)in a 7∶3 ratio using a random number table method.After performing LASSO regression analysis on the training cohort,independent risk factors for PONV were identified,and a nomogram model was established.The predictive efficiency,accuracy,and clinical utility of the model were evaluated using the area under the receiver operating characteristic curve(AUC),calibration curve,and decision curve analysis(DCA).ResultsLASSO regression identified three independent risk factors for PONV in NSCLC patients:gender,weight,and monocyte count.A nomogram predicting PONV risk was constructed,with AUCs of 0.687[95%confidence interval(CI):0.641-0.714]for the training set and 0.683(95%CI:0.656-0.725)for the internal validation set.The calibration plot showed good consistency between predicted and observed values.DCA results indicated maximum clinical benefit when the threshold probability ranged from 8%to 25%.ConclusionThis study constructed and validated the predictive efficacy and clinical utility of a PONV nomogram for NSCLC patients.The predictive model provides a reliable basis for the prevention and treatment of PONV in NSCLC patients.
作者
李会娟
赵迪
王文华
景向娜
杨淑君
Li Huijuan;Zhao Di;Wang Wenhua;Jing Xiangna;Yang Shujun(Department of Anesthesia,Pain and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实验外科杂志》
CAS
2024年第3期582-585,共4页
Chinese Journal of Experimental Surgery
关键词
非小细胞肺癌
术后恶心呕吐
Non-small cell lung cancer
Postoperative nausea and vomiting
