Construction of nomogram model of poor prognosis for patients newly diagnosed with brain metastasis from non-small cell lung cancer based on clinical pathology and prognostic scores.

Abstract

Objective: To explore non-small cell lung cancer (NSCLC) patients with new diagnosis of brain metastasis and construct Logistic regression model based on clinical pathology and prognosis score, and verify.

Methods: A total of 158 patients newly diagnosed with brain metastasis in NSCLC were retrospectively selected from March 2020 to April 2022. The clinical data of patients were collected, and Logistic regression analysis was used to analyze the influencing factors of poor prognosis for newly diagnosed NSCLC with brain metastasis.

Results: The results of univariate analysis showed that the clinical pathological features including NLR>2.94, abnormal CEA, mediastinal lymph node metastasis, symptomatic treatment with therapeutic method, extracranial metastasis and GPS1-2 score were associated with the survival and prognosis of patients with newly diagnosed brain metastasis from NSCLC (P < 0.05). Multivariate Logistic regression analysis showed that NLR>2.94, mediastinal lymph node metastasis, CEA abnormality, extracranial metastasis, and newly diagnosed NSCLC with GPS1-2 score were independent risk factors for poor prognosis of brain metastasis (P < 0.05). Internal verification using the Bootstrap method showed that the predicted curve fitted well with the standard model curve, with the average absolute error of 0.029. The ROC curve result showed that the AUC was 0.887, and the 95%CI was 0.782-0.905, with the corresponding specificity and sensitivity of 90.50% and 80.00%, respectively. This indicates that the prediction accuracy of this Nomogram model is good.

Conclusion: NLR, mediastinal lymph node metastasis, CEA, extracranial metastasis and GPS are risk factors for poor prognosis of newly diagnosed brain metastasis in NSCLC. The risk factor model constructed based on these risk factors has excellent prediction value for the poor prognosis of newly diagnosed brain metastasis in NSCLC. In order to reduce the risk of newly diagnosed brain metastasis in NSCLC and improve the prognosis, targeted preventive measures are taken against the above risk factors in clinical practice.