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基于首次诊断时炎症标志物的列线图对神经母细胞瘤患儿预后的预测

Prediction to the prognosis of children with neuroblastoma by nomogram based on the first-diagnosed inflammatory markers.

作者信息

Zhang Yunlong, Zhang Chenghang, Ma Yue, Li Changchun, Zhao Zhenzhen, Peng Liang, Deng Xiaobin, Zhou Jianwu, Wang Shan

机构信息

Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, No. 136, 2nd Zhongshan Rd, Chongqing, 400010, People's Republic of China.

Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, The National Clinical Research Center for Child Health and Disorders, Chongqing, 400010, People's Republic of China.

出版信息

Pediatr Surg Int. 2022 Nov 30;39(1):17. doi: 10.1007/s00383-022-05302-z.

Abstract

BACKGROUND

Patients with high-risk neuroblastoma (NB) have a poor prognosis. The prognostic significance of inflammatory biomarker-based nomograms for children with NB has not been previously studied.

METHODS

Part of patients diagnosed with NB in our center from January 2016 to March 2022 were included in the study. Inflammatory biomarkers were primary outcome measures, including C-reactive protein (CRP), ferritin, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and systemic immune-inflammation index (SII). Univariate and multivariate survival analyses were performed to assess the prognostic value of these indicators for overall survival (OS) in NB children, showing the Kaplan-Meier survival curves and plotting the nomogram. C-index were used to detect predictability.

RESULTS

93 NB patients were retrospectively analyzed. CRP, ferritin, NLR, PLR, and SII were significantly associated with OS of NB patients, while LMR were found to be not predictive of OS for NB patients. The established nomogram is well-calibrated, and the C-index is 0.731.

CONCLUSION

Survival analysis found part of inflammatory biomarkers related to the prognosis of NB. The nomogram could be used as a convenient predictive tool in clinical practice to evaluate the prognosis of NB children at first diagnosis.

摘要

背景

高危神经母细胞瘤(NB)患者预后较差。基于炎症生物标志物的列线图对NB患儿的预后意义此前尚未得到研究。

方法

纳入2016年1月至2022年3月在本中心诊断为NB的部分患者。炎症生物标志物为主要观察指标,包括C反应蛋白(CRP)、铁蛋白、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)和全身免疫炎症指数(SII)。进行单因素和多因素生存分析,以评估这些指标对NB患儿总生存(OS)的预后价值,绘制Kaplan-Meier生存曲线并绘制列线图。采用C指数检测预测能力。

结果

对93例NB患者进行回顾性分析。CRP、铁蛋白、NLR、PLR和SII与NB患者的OS显著相关,而LMR对NB患者的OS无预测作用。所建立的列线图校准良好,C指数为0.731。

结论

生存分析发现部分炎症生物标志物与NB的预后相关。该列线图可作为临床实践中方便的预测工具,用于评估初诊时NB患儿的预后。

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