Construction of a nomogram prediction model for survival prognosis of patients with advanced non-small cell lung cancer after PD-1 inhibitor treatment
10.3969/j.issn.1673-4130.2023.24.006
- VernacularTitle:晚期非小细胞肺癌患者经PD-1抑制剂治疗后生存预后的列线图预测模型构建
- Author:
Xiongbing LI
1
;
Ruifen ZHOU
;
Jiali LI
;
Hanjiao WANG
;
Chao WANG
;
Jing LI
;
Zhe CAO
;
Chengrong SHU
Author Information
1. 咸宁市中心医院/湖北科技学院附属第一医院 肿瘤科,湖北咸宁 437100
- Keywords:
neutrophil to lymphocyte ratio;
programmed death 1 receptor inhibitor;
advanced non-small cell lung cancer;
nomogram prediction model
- From:
International Journal of Laboratory Medicine
2023;44(24):2975-2979
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of neutrophil to lymphocyte ratio(NLR)and other related in-dicators on the prognosis of advanced non-small cell lung cancer patients treated with programmed death 1(PD-1)inhibitor and construct a nomogram prediction model.Methods A total of 198 patients with advanced non-small cell lung cancer who received PD-1 inhibitor treatment in the hospital from February 2020 to April 2022 were selected and followed up to August 2022.According to the clinical outcome,they were divided into the death group(46 cases)and the survival group(152 cases).The clinical data of the death group and the survival group were recorded,and the prognostic factors of advanced non-small cell lung cancer patients trea-ted with PD-1 inhibitor were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR,platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR)for the prognosis of patients.Multivariate Logistic regression model was used to analyze the independent risk factors affecting the prognosis of patients.A prediction nomogram model for the prognosis of patients was construc-ted using R software 4.0"rms"package,and the calibration curve was used to internally validate the nomo-gram prediction model.Results Compared with the survival group,the proportion of smoking,TNM stageⅣ,ECOG score 2,and NLR,PLR,LMR were higher(P<0.05).The area under the curve of NLR,PLR and LMR were 0.707,0.793 and 0.819,respectively,and the optimal cut-off value were 4.72%,179.21%and 3.44%,respectively.Smoking,TNM stage,ECOG score,NLR,PLR,and LMR were independent risk factors for the prognosis of advanced non-small cell lung cancer patients treated with PD-1 inhibitor(P<0.05).The internal validation results show that the nomogram inhibitor treatment of PD-1 model prediction the prognosis of patients with advanced non-small cell lung cancer C-index was 0.847(95%CI 0.769-0.902),the calibra-tion curve tends to be the ideal curve.The threshold value of the nomogram model for predicting the prognosis of patients with advanced non-small cell lung cancer treated with PD-1 inhibitor was>0.22.The nomogram prediction model provided a net clinical benefit,and the net clinical benefit was higher than that of smoking,TNM stage,ECOG score,NLR,PLR and LMR.Conclusion Based on smoking,TNM stage,ECOG score,NLR,PLR,and LMR,a nomogram prediction model for the prognosis of advanced non-small cell lung cancer patients treated with PD-1 inhibitor is constructed,which has important clinical application value.
