Analysis of Influencing Factors and Establishment of Risk Prediction Model of Liver Injury in Patients with NSCLC Caused by PD-1 Inhibitor

OBJECTIVE  To analyze the influencing factors of liver injury in patients with non-small cell lung cancer(NSCLC) induced by PD-1 inhibitors, and to construct a risk prediction model and line map.

METHODS  A total of 249 NSCLC patients treated with PD-1 inhibitors at the First Affiliated Hospital of Xiamen University from January 2019 to December 2023 were retrospectively analyzed. The patients were divided into liver injury group and non-liver injury group according to the presence or absence of liver injury. The clinical data of the patients were analyzed, Logistic regression analysis was used to explore the influencing factors of liver injury, and then the nomogram was drawn according to the influencing factors, and the model was tested.

RESULTS Among the 249 patients, 60(24.10%) patients had different degrees of liver injury, and 189(75.9%) patients did not have liver injury. Age, medication stage, large cell carcinoma type, drinking history, white blood cell count(WBC) were the influencing factors of liver injury. The C-index of the nomogram model was 0.746(95%CI: 0.600−0.836). The kappa value of model validation was 0.160. The decision curve showed that the net benefit value of the model was higher when the threshold probability was in the range of 5%−73%.

CONCLUSION  Age, stage of treatment, large cell carcinoma, drinking history, and WBC are the influencing factors of liver injury in patients with NSCLC induced by PD-1 inhibitor, and the model has a good construction effect.