两种工具在原发性肝癌患者经动脉化疗栓塞术后延迟性化疗相关恶心呕吐风险评估中的比较

目的比较延迟性化疗相关恶心呕吐风险指数(DCINV-RI)、化疗相关恶心呕吐风险预测工具(CINV-RPT)在原发性肝癌患者经动脉化疗栓塞术后延迟性化疗相关恶心呕吐(DCINV)风险评估中的预测价值。方法采用便利抽样法,选取2020年5月—2021年5月在江苏省肿瘤医院介入治疗科行动脉化疗栓塞术治疗的212例原发性肝癌患者为研究对象,根据DCIVN发生与否将患者分为对照组(n=80)和DCIVN组(n=132)。应用DCINV-RI和CINV-RPT对患者进行DCINV风险评估,采用受试者工作特征曲线下面积(AUC)、灵敏度、特异度和约登指数比较两种工具的预测价值。结果212例原发性肝癌患者中,62.26%(132/212)的患者发生2级及以上DCINV。使用两种工具进行DCINV风险评估时,DCINV组患者评分均高于对照组,差异均具有统计学意义(P<0.01)。DCINV-RI评分的AUC为0.852,当总分为20.500分时,灵敏度、特异度、约登指数为0.838、0.765、0.603(P<0.01),此时DCINV-RI的预测价值最大;CINV-RPT评分的AUC为0.924,当总分为12.500分时,灵敏度、特异度、约登指数为0.863、0.841、0.703(P<0.01),此时CINV-RPT预测价值最大;CINV-RPT评分的AUC、灵敏度、特异度、约登指数均高于DCINV-RI评分。结论原发性肝癌患者经动脉化疗栓塞术后DCINV发生率处于较高水平,DCINV-RI和CINV-RPT均能有效预测原发性肝癌患者经动脉化疗栓塞术后DCINV发生风险,但CINV-RPT的预测价值高于DCINV-RI。

Comparison of two tools for risk assessment of delayed chemotherapy-related nausea and vomiting after arterial chemoembolization in patients with primary liver cancer

Objective To compare the predictive value of the Delayed Chemotherapy Induced Nausea and Vomiting Risk Index(DCINV-RI)and the Chemotherapy Induced Nausea and Vomiting Risk Prediction Tool(CINV-RPT)in the risk assessment of delayed chemotherapy induced nausea and vomiting(DCINV)after arterial chemoembolization in patients with primary liver cancer.Methods From May 2020 to May 2021,convenience sampling was used to select 212 primary liver cancer patients with arterial chemoembolization in the Department of Intervention Therapy of Jiangsu Cancer Hospital as the research object.The patients were divided into the control group(n=80)and the DCIVN group(n=132)according to the occurrence of DCIVN.DCINV risk assessment of patients was performed using DCINV-RI and CINV-RPT.Area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and Youden index were used to compare the predictive value of the two tools.Results Among the 212 patients with primary liver cancer,62.26%(132/212)had grade 2 or above DCINV.When using the two tools for DCINV risk assessment,the scores of patients in the DCINV group were higher than those in the control group,and the difference was statistically significant(P<0.01).The AUC for the DCINV-RI score was 0.852.When the total score was 20.500 points,the sensitivity,specificity,and Youden index were 0.838,0.765,and 0.603 respectively(P<0.01),and the predictive value of DCINV-RI was the greatest at this point.The AUC of the CINV-RPT score was 0.924.When the total score was 12.500,the sensitivity,specificity and Youden index were 0.863,0.841,and 0.703 respectively(P<0.01),and the predictive value of CINV-RPT was the greatest at this point.The AUC,sensitivity,specificity and Youden index of CINV-RPT score were higher than those of DCINV-RI score,and the difference was significantly statistical.Conclusions The incidence of DCINV in patients with primary liver cancer after arterial chemoembolization is at a high level.Both DCINV-RI and CINV-RPT can effectively predict the risk of DCINV in patients with primary liver cancer after arterial chemoembolization,but the predictive value of CINV-RPT is higher than that of DCINV-RI.