Risk assessment of pleural metastasis in patients with stage Ⅲ lung cancer based on a serum tumor markers Nomogram model
10.3969/j.issn.1673-4130.2025.16.012
- VernacularTitle:基于血清肿瘤标志物列线图模型的Ⅲ期肺癌患者胸膜转移风险评估
- Author:
Shengmei LI
1
;
Jun JIA
;
Xiuqing MA
;
Caihua FENG
;
Huiping QING
Author Information
1. 青海红十字医院检验科,青海西宁 810000
- Keywords:
lung cancer;
tumor markers;
pleural metastasis;
Nomogram model
- From:
International Journal of Laboratory Medicine
2025;46(16):1984-1989,1994
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish a Nomogram model based on serum tumor markers to assess the risk of pleural metastasis in patients with stage Ⅲ lung cancer,and to validate the constructed model.Methods A to-tal of 140 patients with stage Ⅲ lung cancer in the hospital from January 2022 to October 2024 were selected as the research subjects.They were divided into the metastasis group(36 cases)and the non-metastasis group(104 cases)based on whether pleural metastasis occurred.Clinical data of patients in the two groups were col-lected,and the levels of serum tumor markers[carcinoembryonic antigen(CEA),cancer antigen(CA)125,CA15-3,CA19-9]of patients in the two groups were detected simultaneously.The risk factors affecting pleural metastasis in patients with stage Ⅲ lung cancer were screened,and the risk of pleural metastasis in patients with stage Ⅲ lung cancer was evaluated by constructing a Nomogram model based on serum tumor markers,and the constructed prediction model was validated.Results The proportion of smoking history,maximum tumor diameter≥4 cm,lymph node metastasis and low differentiation in metastatic group were higher than those in non-metastatic group(P＜0.05).Compared with non-metastatic group,serum CEA,CA125,CA15-3 and CA19-9 levels in metastatic group were higher(P＜0.05).Multiuariate Logistic regression analysis showed that lymph node metastasis,low differentiation and abnormal increase of CEA,CA125,CA15-3 and CA19-9 levels were independent risk factors for pleural metastasis in stage Ⅲ lung cancer patients(P＜0.05).The area under the receiver operating characteristic curve of the Nomogram model constructed based on serum tumor markers was 0.896(95％CI:0.812-0.991),which proved that the model had good predic-tive efficacy.The calibration curve of the model confirmed that there was a good agreement between the pre-dicted risk and the actual risk,and the Hosmer-Lemeshow goodness of fit curve test x2=1.602,P=0.638.The results of the decision curve analysis show that this model could achieve a relatively high net benefit with-in the range of 0％to 80％.Conclusion The Nomogram model based on serum tumor markers can effectively evaluate the risk of pleural metastasis in patients with stage Ⅲ lung cancer,and has good calibration,goodness of fit and clinical practicability.
