肿瘤负荷对晚期肺癌预后的影响及 预测模型的构建

The Impact of Tumor Burden on the Prognosis of Advanced Lung Cancer and the Construction of a Predictive Model

摘要: 目的：探究肿瘤负荷等多因素对晚期肺癌患者无进展生存期(PFS)的影响及预测模型的构建。方法：回顾性分析了243例治疗后进展的晚期肺癌患者，根据肿瘤负荷分为3组。收集临床特征等资料，采用Kaplan-Meier法比较各组PFS，并通过Cox回归分析疾病进展的影响因素，构建肺癌预后的多因素Cox预测模型。结果：Kaplan-Meier曲线结果显示，肿瘤负荷越高，PFS越低。多因素Cox分析结果显示，男性患者、肾上腺转移瘤、肝脏转移瘤、低QoL评分为短PFS的独立危险因素。基于此构建的多因素Cox预测模型，其预测1年、2年及3年肿瘤进展的AUC值分别为0.681、0.705和0.827。结论：肿瘤负荷越高，晚期肺癌患者PFS越低，男性、肾上腺转移、肝转移及低生活质量是晚期肺癌快速进展的独立危险因素，据此构建的Cox预测模型准确性较好。

Abstract: Objective: To investigate the influence of multiple factors such as tumor burden on the progression-free survival (PFS) of patients with advanced lung cancer and to construct a predictive model. Methods: A retrospective analysis was conducted on 243 patients with advanced lung cancer who experienced disease progression after treatment. These patients were divided into three groups based on tumor burden. Clinical characteristics and other data were collected. The Kaplan-Meier method was used to compare the PFS of each group, and Cox regression analysis was employed to identify the influencing factors of disease progression. A multivariate Cox prediction model for lung cancer prognosis was constructed. Results: The Kaplan-Meier curve results indicated that the higher the tumor burden, the lower the PFS. The multivariate Cox analysis results showed that male patients, adrenal metastases, liver metastases, and low QoL scores were independent risk factors for short PFS. Based on this, the constructed multivariate Cox prediction model had AUC values of 0.681, 0.705, and 0.827 for predicting tumor progression at 1 year, 2 years, and 3 years, respectively. Conclusion: The higher the tumor burden, the lower the PFS for patients with advanced lung cancer. Male gender, adrenal metastasis, liver metastasis, and low quality of life are independent risk factors for the rapid progression of advanced lung cancer. The constructed Cox prediction model has good accuracy based on these factors.