A nomogram prediction model for interstitial pneumonia associated with targeted therapy+chemotherapy for recurrent drug-resistant ovarian cancer based on ALB,LDH,IL-17,and TNF-α

WANG Jun; FAN Sufang; ZHAO Fojun; ZHAO Yaning; GUI Feng

doi:10.3969/j.issn.2097-1753.2025.02.006

Abstract：Objective To explore the levels of serum albumin(ALB),lactate dehydrogenase(LDH),interleukin-17(IL-17),and tumor necrosis factor alpha(TNF-α)in patients with interstitial pneumonia(IP)who received targeted therapy and chemotherapy for recurrent drug-resistant ovarian cancer(RDROC),and to construct a nomogram prediction model for IP based on these levels.Methods A total of 80 patients with RDROC who had been treated for IP related to targeted therapy+chemotherapy in Zhangjiakou Xuangang Hospital between June 2020 and June 2022 were assigned to the study group while another 80 patients with RDROC who had not were selected as the control group.The clinical data and serum levels of ALB,LDH,IL-17,and TNF-α were compared between the two groups.A logistic regression model was used to analyze the contributors to IP.A nomogram prediction model was constructed according to these contributors,whose prediction efficiency and clinical applicability were evaluated.Results Age,percentages of patients in primary FIGO stage Ⅲ-Ⅳ,with preexisting lung diseases,or with a history of smoking,and serum levels of LDH,IL-17,and TNF-α in the study group were higher than those of the control group(t=4.006-21.973,all P＜0.001),while the ALB level was lower(t=7.118,P＜0.001).The serum level of ALB in patients with acute exacerbation was lower than that of patients in stable condition(t=5.311,P＜0.001),but levels of LDH,IL-17,and TNF-α were higher(t=3.712,4.390,14.132,all P＜0.001).Preexisting lung diseases(OR=6.152,95％CI:2.406-15.729),smoking(OR=5.017,95％CI:1.965-12.810),serum LDH(OR=3.642,95％CI:1.733-7.652),IL-17(OR=4.889,95％CI:2.267-10.543),and TNF-α(OR=8.064,95％CI:3.012-21.591)were all independent risk factors for the occurrence of IP in patients with RDROC undergoing targeted therapy+chemotherapy,while serum ALB(OR=0.426,95％CI:0.215-0.843)was an independent protective factor(all P＜0.001).ROC analysis showed that the AUC of the nomogram prediction model was 0.887 for predicting the occurrence of IP,with a good predictive performance.Conclusion Preexisting lung diseases,smoking,serum LDH,IL-17,and TNF-αare all independent risk factors for IP in patients with RDROC undergoing targeted therapy+chemotherapy.Serum ALB is an independent protective factor.A nomogram prediction model has been constructed,which can help predict the occurrence of IP.