Analysis Of The Proportion Of Non-smoking Female Patients In Early Lung Cancer And Establishment Of Nomogram

Background:Lung cancer is one of the most common malignant tumors in the world,once considered a smoking-related disease.In recent years,with the changes of smoking habits in China,industrialization causing serious environmental pollution,and aging caused by continuous population growth,the composition of lung cancer patients may have changed significantly,such as the proportion of various pathological types,the proportion of different genders and the proportion of patients in the age group.The proportion of female non-smoking adenocarcinoma patients increased significantly.Although there are many studies on the prognosis of lung cancer,and the analysis of the prognosis of this special group of female non-smoking adenocarcinoma patients is insufficient,a simple,efficient and clinically practical model is lacking to facilitate the prognosis of such patients.Methods:First,we retrospectively reviewed 8,668 lung cancer patients undergone surgery from January 1,1990 to December 31 at Shandong Provincial Hospitals,China.By reviewing the medical record system of the Provincial Hospital Affiliated to collect the information,including age,gender,smoking history and pathological types to analyze the Proportion change of lung cancer.Then,we collected the age,sex,family history,smoking history,pathological type,WBC,hemoglobin,Platelet,alanine aminotransferase,blood creatinine,surgical method,tumor characteristics(TNM stage,tumor diameter,degree of differentiation)of 407 female non-smoking lung adenocarcinoma patients who underwent surgery from January 1,2006 to December 31,2012.We performed univariate and multivariate COX regression analysis and Kaplan-Meier survival analysis to identify the independent prognostic factors of female never-smoke adenocarcinoma patients through SPSS 24.0.The 5 independent prognostic factors were used to construct a nomogram to assess the prognosis of such patients(R3.6.2).Results:The proportion of lung cancer patients has changed recent years.The proportion of non-smokers with lung cancer has increased significantly,and this upward trend was particularly evident in lung adenocarcinoma.The proportion of female lung cancer patients has increased significantly,and the majority of female lung cancer patients suffered from LUAD.Therefore,the proportion of female non-smokers with adenocarcinoma has increased significantly compared with before.407 non-smoking female adenocarcinoma patients and 1026 other lung cancer patients were included to construct the nomogram.Non-smoking female adenocarcinoma patients performed a better prognosis than other lung cancer patients(p=0.024).Five independent prognostic factors were identified and integrated into the model.The calibration curves showed good agreement.In primary cohort,the concordance index(C-index)(0.816,95%CI=0.741-0,831)of the nomogram was higher than that of the staging system(0.737,95%CI=0.686-0.788).In training cohort,the C-index(0.748,95%CI=0.668-0.82)of the nomogram was higher than that of the staging system(0.732,95%CI=0.658-0.805).The AUC of the 3-year and 5-year survival was 0.816,0.799,0.764 and 0.705 respectively in primary and validation cohort.Conclusions:The nomogram constructed in this study could assess prognosis of female never-smoke adenocarcinoma patients more accurate,compared with the traditional evaluation method TNM staging.