Nomogram based on homogeneous and heterogeneous associated factors for predicting bone metastases in patients with different histological types of lung cancer
Nomogram based on homogeneous and heterogeneous associated factors for predicting bone metastases in patients with different histological types of lung cancer
复制标题
基于同质和异质相关因素的列线图预测不同组织学类型肺癌患者的骨转移
DOI：
10.1186/s12885-019-5445-3
复制
发表时间：
2019-03-15
期刊：
影响因子：
3.8
通讯作者：
Wang, Guowen
中科院分区：
文献类型：
--
作者：
Zhang, Chao;Mao, Min;Wang, Guowen
本研究的目的是描述不同组织学类型肺癌的患病率、相关因素，并构建预测骨转移（BM）的nomogram。患者和方法本研究是一项描述性研究，基于2010 - 2014年监测、流行病学和最终结果项目中诊断的浸润性肺癌患者。共检索了125,652名成年患者。进行了Logistic回归分析，以调查脑脊髓炎发生的同质和异质因素。构建Nomogram来预测患者发展为BM的风险，并通过受试者工作特征曲线（ROC）和校准曲线对其性能进行评价。采用Kaplan-Meier法分析BM患者的总生存期，采用log-rank检验检验生存差异。结果报告BM 25645例（20.9%），其中腺癌、鳞状细胞癌、小细胞肺癌（SCLC）、大细胞肺癌（LCLC）、非小细胞肺癌/非特异性肺癌（NSCLC/NOS）患病率分别为24.4%、12.5、24.7%、19.5%、19.4%，差异有统计学意义（P< 0.001）。在所有肺癌亚型中，男性、更多的转移部位和淋巴转移与脑转移呈正相关。在除NSCLC/NOS外的所有肺癌亚型中，较大的肿瘤大小与BM呈正相关。低分化组织学与腺癌、鳞状细胞癌和NSCLC/NOS呈正相关。校正曲线和ROC曲线对脑损伤有较好的预测效果。骨转移肺癌患者的中位生存期为4.00个月（95%CI: 3.89-4.11）。随着其他转移部位（脑、肺、肝）转移数量的增加，生存率显著降低（p< 0.001）。结论不同的肺癌组织学亚型表现出不同的患病率以及与脑转移相关的异质性和同质性因素。该图对预测肺癌脑转移具有良好的校准和判别性。
BackgroundThe purpose of the present study was to characterize the prevalence, associated factors, and to construct a nomogram for predicting bone metastasis (BM) with different histological types of lung cancer.Patients and methodsThis study was a descriptive study that basing on the invasive lung cancer patients diagnosed between 2010 and 2014 in Surveillance, Epidemiology, and End Results program. A total of 125,652 adult patients were retrieved. Logistic regression analysis was conducted to investigate homogeneous and heterogeneous factors for BM occurrence. Nomogram was constructed to predict the risk for developing BM and the performance was evaluated by the receiver operating characteristics curve (ROC) and the calibration curve. The overall survival of the patients with BM was analyzed using the Kaplan–Meier method and the survival differences were tested by the log-rank test.ResultsA total of 25,645 (20.9%) were reported to have BM, and the prevalence in adenocarcinoma, squamous cell carcinoma, small cell lung cancer (SCLC), large cell lung cancer (LCLC), and non-small cell lung cancer/not otherwise specified lung cancer (NSCLC/NOS) were 24.4, 12.5, 24.7, 19.5 and 19.4%, respectively, with significant difference (P< 0.001). Male gender, more metastatic sites and lymphatic metastasis were positively associated with BM in all lung cancer subtypes. Larger tumor size was positively associated with BM in all the lung cancer subtypes except for NSCLC/NOS. Poorly differentiated histology was positively associated with adenocarcinoma, squamous cell carcinoma and NSCLC/NOS. The calibration curve and ROC curve exhibited good performance for predicting BM. The median survival of the bone metastatic lung cancer patients was 4.00 (95%CI: 3.89–4.11) months. With the increased number of the other metastatic sites (brain, lung and liver metastasis), the survival significantly decreased (p< 0.001).ConclusionDifferent lung cancer histological subtypes exhibited distinct prevalence and homogeneity and heterogeneity associated factors for BM. The nomogram has good calibration and discrimination for predicting BM of lung cancer.