[1]徐飞,田龙.基于列线图模型的前列腺癌黄金基准标志物安全性的影响因素[J].中国医学物理学杂志,2025,42(2):154-159.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.003]
　XU Fei,TIAN Long.Nomogram model based analysis on factors affecting the safety of gold fiducial markers in prostate cancer[J].Chinese Journal of Medical Physics,2025,42(2):154-159.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.003]
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基于列线图模型的前列腺癌黄金基准标志物安全性的影响因素()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第2期
页码:
154-159
栏目:
医学放射物理
出版日期:
2025-01-20

文章信息/Info

Title:
Nomogram model based analysis on factors affecting the safety of gold fiducial markers in prostate cancer
文章编号:
1005-202X（2025）02-0154-06
作者:
徐飞; 田龙
中国医科大学附属盛京医院肿瘤科放射治疗室， 辽宁 沈阳 110022
Author(s):
XU Fei;  TIAN Long
Radiotherapy Room, Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110022, China
关键词:
前列腺癌; 列线图; 黄金基准标志物; 安全性; 影响因素
Keywords:
Keywords: prostate cancer nomogram gold fiducial marker safety influence factor
分类号:
R737.25；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2025.02.003
文献标志码:
A
摘要:
目的：基于列线图（Nomogram）模型分析前列腺癌（PCa）放疗中黄金基准标志物（GFM）置入后安全性的影响因素，评价模型的临床应用价值。方法：选取600例接受了GFM置入术的PCa患者，将其随机分为训练集和验证集。设置标志物间距阈值为1 mm，将训练集患者再次分为GFM置入后安全组和风险组。采用多因素Logistic回归分析训练集患者GFM置入后安全性影响因素，基于结果和R语言4.0“rms”软件包创建Nomogram预测模型。通过绘制校准曲线和临床决策曲线完成内部验证。通过绘制训练集和验证集ROC曲线以及计算AUC完成外部验证。结果：多因素Logistic回归分析结果显示，前列腺体积<25 mL、GFM置入底部、置入4枚、轴皮比均值为1~2或2~3是影响GFM置入后安全性的独立风险因素（P<0.05）。基于上述5个独立风险因素创建了Nomogram预测模型。内部验证结果显示：模型一致性良好且能够提供临床净收益。外部验证结果显示：模型预测训练集和验证集GFM置入后安全性的ROC曲线拟合较为理想（[χ2]=3.224, P=0.254），AUC分别为0.876（95%CI：0.724~0.903）和0.865（95%CI：0.702~0.897），差异无统计学意义（P=0.341）。结论：GFM置入后安全性Nomogram模型预测效能可满足临床要求。作为一种新型评价工具，该模型可进一步提高GFM的临床应用价值。
Abstract:
Abstract: Objective To analyze the factors affecting the safety after gold fiducial markers (GFM) insertion for prostate cancer radiotherapy based on the nomogram model, and to evaluate the clinical application potential of the proposed model. Methods A total of 600 prostate cancer patients who underwent GFM insertion were randomly assigned to training set and test set. The inter-marker distance was set at a queue value of 1 mm, and the patients in training set were further divided into safety and risk subgroups after GFM insertion. Multivariate Logistic regression was used to analyze the influence factors for the safety after GFM insertion in training set. A nomogram prediction model was constructed using the obtained results and R language 4.0 "rms" software package. Internal validation was completed with calibration curves and clinical decision curves, while external validation was completed by plotting receiver operating characteristic curves and calculating area under the curve (AUC) in training and test sets. Results Multivariate Logistic regression analysis identified prostate volume <25 mL, insertion at the bottom, insertion of 4 markers, and average axial-to-surface ratio of 1-2 or 2-3 as the independent risk factors for the safety after GFM insertion (P<0.05) to construct a nomogram prediction model. The internal validation results showed that the model had good consistency and could provide clinical net benefits. External validation results revealed that ROC curves for predicting the safety after GFM insertion in training set and test set were well fitted ([χ2]=3.224, P=0.254). The AUC were 0.876 (95%CI: 0.724-0.903) and 0.865 (95%CI: 0.702-0.897), respectively, without statistically significant differences (P=0.341). Conclusion The nomogram model for the safety after GFM insertion exhibits satisfactory prediction efficiency, and it serving as a new evaluation tool can further improve the clinical application value of GFM.

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备注/Memo

备注/Memo:
【收稿日期】2024-07-28 【基金项目】辽宁省医学科学研究项目（20240589） 【作者简介】徐飞，技师，研究方向：前列腺肿瘤，E-mail: 1277473912@qq.com
更新日期/Last Update: 2025-01-22