
浏览全部资源
扫码关注微信
1.重庆医科大学附属第一医院乳腺甲状腺外科,重庆 400016
2.重庆医科大学护理学院,重庆 400016
邱 菊,Email:qiujuchongyi@163.com,研究方向:乳腺肿瘤护理,老年护理,护理教育。
孔令娜,Email:konglingna926@126.com。
收稿:2025-07-17,
修回:2025-11-17,
录用:2025-11-18,
纸质出版:2026-05-28
移动端阅览
邱菊,孔令娜,王温馨,等.FRAIL量表在乳腺癌患者衰弱评估中的诊断性能研究[J].重庆医科大学学报,2026,51(5):638-644.
Qiu Ju,Kong Lingna,Wang Wenxin,et al.Diagnostic performance of the FRAIL scale in the assessment of frailty among patients with breast cancer[J].Journal of Chongqing Medical University,2026,51(5):638-644.
邱菊,孔令娜,王温馨,等.FRAIL量表在乳腺癌患者衰弱评估中的诊断性能研究[J].重庆医科大学学报,2026,51(5):638-644. DOI: 10.13406/j.cnki.cyxb.004009.
Qiu Ju,Kong Lingna,Wang Wenxin,et al.Diagnostic performance of the FRAIL scale in the assessment of frailty among patients with breast cancer[J].Journal of Chongqing Medical University,2026,51(5):638-644. DOI: 10.13406/j.cnki.cyxb.004009.
目的
2
本研究以Fried衰弱表型(Fried frailty phenotype,FFP)为衰弱诊断标准,确定衰弱筛查量表FRAIL(The FRAIL Scale,FRAIL)在乳腺癌患者中的衰弱诊断性能。
方法
2
采用方便抽样法,使用FFP和FRAIL量表对320例乳腺癌患者进行衰弱评估。使用Cohen’s Kappa系数评价FFP和FRAIL量表之间的一致性,采用受试者工作特征曲线(receiver operating characteristic,ROC)分析FRAIL量表对乳腺癌患者的衰弱诊断准确性;根据约登指数最大原则确定FRAIL量表的最佳截断值,并分别计算在原始和最佳临界值时的诊断性能指标;运用Bayes判别分析,评估FRAIL量表对乳腺癌患者衰弱风险的预测效能。
结果
2
FFP和FRAIL量表评估的乳腺癌患者的衰弱发生率分别为17.2%和30.6%。一致性检验的Kappa值为0.381(
P
<
0.05);FRAIL量表对乳腺癌患者衰弱诊断的ROC曲线下面积为0.898(95%CI=0.856~0.939)。当截断值为2分时,FRAIL量表的灵敏度为92.5%,特异度为65.0%。模型判别效能的交叉验证结果显示,总体正确分类率为80.9%。
结论
2
FRAIL量表具有良好的诊断性能,适用于乳腺癌患者的衰弱评估。
Objective
2
To investigate the diagnostic performance of the FRAIL scale in the assessment of frailty among patients with breast cancer with Fried Frailty Phenotype(FFP) as the diagnostic criteria for frailty.
Methods
2
The convenience sampling method was used to select 320 patients with breast cancer,and FFP and the FRAIL scale were used to assess frailty in these patients. The Cohen’s Kappa coefficient was used to investigate the consistency between the FRAIL scale and FFP,and the receiver operating characteristic (ROC) curve was used to assess the accuracy of the FRAIL scale in the diagnosis of frailty in patients with breast cancer. The optimal cut-off value of the FRAIL scale was determined based on the maximum Youden index principle,and the indicators for diagnostic performance were calculated at the original value and the optimal cut-off value. The Bayesian discriminant analysis was used to evaluate the accuracy of the FRAIL scale in predicting the risk of frailty in patients with breast cancer.
Results
2
In the patients with breast cancer,the incidence rate of frailty was 17.2% based on FFP and 30.6% based on the FRAIL scale. The consistency test yielded a Cohen’s Kappa coefficient of 0.381(
P
<
0.05). The FRAIL scale had an area under the ROC curve of 0.898 (95%CI=0.856-0.939) in the diagnosis of frailty in the patients with breast cancer,with a sensitivity of 92.5% and a specificity of 65.0% at the optimal cut-off value of 2. The FRAIL scale had a cross-validation accuracy of 80.9% in predicting the risk of frailty.
Conclusion
2
The FRAIL scale has good diagnostic performance and can be used for the assessment of frailty in patients with breast cancer.
Giaquinto AN , Sung H , Miller KD , et al . Breast cancer statistics,2022 [J ] . CA A Cancer J Clin , 2022 , 72 ( 6 ): 524 - 541 .
Carroll JE , Bower JE , Ganz PA . Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care [J ] . Nat Rev Clin Oncol , 2022 , 19 ( 3 ): 173 - 187 .
Gilmore N , Kadambi S , Lei LL , et al . Associations of inflammation with frailty in patients with breast cancer aged 50 and over receiving chemotherapy [J ] . J Geriatr Oncol , 2020 , 11 ( 3 ): 423 - 430 .
Dent E , Martin FC , Bergman H , et al . Management of frailty:opportunities,challenges,and future directions [J ] . Lancet , 2019 , 394 ( 10206 ): 1376 - 1386 .
Wang SR , Yang T , Qiang WM , et al . The prevalence of frailty among breast cancer patients:a systematic review and meta-analysis [J ] . Support Care Cancer , 2022 , 30 ( 4 ): 2993 - 3006 .
Liu E , Saulnier PJ , Gand E , et al . Frailty and diabetes status in older patients with cancer:impact on mortality in the ANCRAGE cohort [J ] . Aging Clin Exp Res , 2020 , 32 ( 9 ): 1809 - 1819 .
Coleman C , Yan CH , Ko NY , et al . Physical functioning,frailty and risks of locally-advanced breast cancer among older women [J ] . Breast , 2022 , 64 : 19 - 28 .
Williams GR , Deal AM , Sanoff HK , et al . Frailty and health-related quality of life in older women with breast cancer [J ] . Support Care Cancer , 2019 , 27 ( 7 ): 2693 - 2698 .
Bieniek J , Wilczyński K , Szewieczek J . Fried frailty phenotype assessment components as applied to geriatric inpatients [J ] . Clin Interv Aging , 2016 , 11 : 453 - 459 .
Fried LP , Tangen CM , Walston J , et al . Frailty in older adults:evidence for a phenotype [J ] . J Gerontol A Biol Sci Med Sci , 2001 , 56 ( 3 ): M146 - M156 .
Auyeung TW , Lee JSW , Leung J , et al . The selection of a screening test for frailty identification in community-dwelling older adults [J ] . J Nutr Health Aging , 2014 , 18 ( 2 ): 199 - 203 .
Van Kan GA , Rolland Y , Bergman H , et al . The I. A. N. A. task force on frailty assessment of older people in clinical practice [J ] . J Nutr Health Aging , 2008 , 12 ( 1 ): 29 - 37 .
卫尹 , 曹艳佩 , 杨晓莉 , 等 . 老年住院患者衰弱综合征现状及影响因素 [J ] . 复旦学报(医学版) , 2018 , 45 ( 4 ): 496 - 502 .
Wei Y , Cao YP , Yang XL , et al . Frailty syndrome in hospitalized geriatric patients and its risk factors [J ] . Fudan Univ J Med Sci , 2018 , 45 ( 4 ): 496 - 502 .
Zeng L , Kong LN , Fang Q , et al . Diagnostic accuracy of the FRAIL scale for frailty screening in community-dwelling older adults with diabetes:A cross-sectional study [J ] . Geriatr Nurs , 2023 , 52 : 115 - 120 .
Dong LJ , Qiao XX , Tian XY , et al . Cross-cultural adaptation and validation of the FRAIL scale in Chinese community-dwelling older adults [J ] . J Am Med Dir Assoc , 2018 , 19 ( 1 ): 12 - 17 .
Mandrekar JN . Receiver operating characteristic curve in diagnostic test assessment [J ] . J Thorac Oncol , 2010 , 5 ( 9 ): 1315 - 1316 .
韩君 , 王君俏 , 谢博钦 , 等 . Fried衰弱表型和FRAIL量表及埃德蒙顿衰弱评估量表在社区高龄老年人衰弱筛查中一致性和适用性的比较研究 [J ] . 中国全科医学 , 2021 , 24 ( 21 ): 2669 - 2675 .
Han J , Wang JQ , Xie BQ , et al . Comparison of consistency and validity of fried frailty phenotype,FRAIL scale and Edmonton frailty scale for frailty screening among community-dwelling older adults [J ] . Chin Gen Pract , 2021 , 24 ( 21 ): 2669 - 2675 .
Bennett JA , Winters-Stone KM , Dobek J , et al . Frailty in older breast cancer survivors:age,prevalence,and associated factors [J ] . Oncol Nurs Forum , 2013 , 40 ( 3 ): E126 - E134 .
路平 , 郭海凌 , 王晓杰 , 等 . 老年乳腺癌患者术前衰弱现状及其影响因素分析 [J ] . 中国护理管理 , 2023 , 23 ( 5 ): 670 - 675 .
Lu P , Guo HL , Wang XJ , et al . Frailty status and its influencing factors in elderly preoperative breast cancer patients [J ] . Chin Nurs Manag , 2023 , 23 ( 5 ): 670 - 675 .
Cheung DST , Ho MH , Chau PH , et al . Screening for frailty using the FRAIL scale in older cancer survivors:a cross-sectional comparison with the fried phenotype [J ] . Semin Oncol Nurs , 2024 , 40 ( 2 ): 151617 .
Jung HW , Jang IY , Lee YS , et al . Prevalence of frailty and aging-related health conditions in older koreans in rural communities:a cross-sectional analysis of the aging study of pyeongchang rural area [J ] . J Korean Med Sci , 2016 , 31 ( 3 ): 345 - 352 .
Ambagtsheer RC , Visvanathan R , Dent E , et al . Commonly used screening instruments to identify frailty among community-dwelling older people in a general practice(primary care) setting:a study of diagnostic test accuracy [J ] . J Gerontol A Biol Sci Med Sci , 2020 , 75 ( 6 ): 1134 - 1142 .
Lim SH , Malhotra R , Østbye T , et al . Sensitivity and specificity of three screening tools for frailty in hospitalized older adults [J ] . Int J Nurs Stud , 2023 , 139 : 104435 .
Clegg A , Rogers L , Young J . Diagnostic test accuracy of simple instruments for identifying frailty in community-dwelling older people:a systematic review [J ] . Age Ageing , 2015 , 44 ( 1 ): 148 - 152 .
Lim YJ , Ng YS , Sultana R , et al . Frailty assessment in community-dwelling older adults:a comparison of 3 diagnostic instruments [J ] . J Nutr Health Aging , 2020 , 24 ( 6 ): 582 - 590 .
Biganzoli L , Battisti NML , Wildiers H , et al . Updated recommendations regarding the management of older patients with breast cancer:a joint paper from the European Society of Breast Cancer Specialists ( EUSOMA ) and the International Society of Geriatric Oncology(SIOG) [J ] . Lancet Oncol , 2021 , 22 ( 7 ): e327 - e340 .
0
浏览量
5
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621