构建宫颈高级别鳞状上皮内病变患者术后复发风险的预测模型  

Construction of a predictive model for the risk of postoperative relapse in patients with cervical high-grade squamous intraepithelial lesions

作　　者：聂含慧 蔡芸凤 张艳荣 NIE Hanhui;CAI Yunfeng;ZHANG Yanrong(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Henan University,Henan,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院妇产科,河南开封475000

出　　处：《中国医药科学》2022年第10期13-16,共4页China Medicine And Pharmacy

基　　金：河南省医学教育研究项目(Wjlx2017098)。

摘　　要：目的分析宫颈高级别鳞状上皮内病变术后复发的危险因素并构建预测术后复发的回归模型。方法收集2016年1月至2020年8月河南大学第一附属医院因宫颈高级别鳞状上皮内病变而行宫颈锥切术的362例患者的临床资料,依据随访期间复发与否将患者分为复发组(n=40)和未复发组(n=322),采用单因素及多因素分析患者术后复发的危险因素并构建预测模型,应用受试者工作特征(ROC)曲线及Hosmer-Lemeshow(H-L)拟合优度检验评估该模型的预测效能。结果单因素分析结果显示,术后复发与绝经状况(P=0.006)、切缘状态(P=0.006)、术后HPV感染(P=0.002)显著相关;多因素分析结果显示,术后复发与已绝经(P=0.004)、切缘阳性(P=0.003)、术后HPV感染(P=0.002)呈独立相关。H-L拟合优度检验结果为χ^(2)=2.859、P>0.05,ROC曲线下面积(AUC)为0.710。结论所构建的回归模型可有效预测宫颈高级别鳞状上皮内病变患者术后复发的风险。Objective To analyze the risk factors for relapse of cervical high-grade squamous intraepithelial lesions(HGSIL)after surgery and construct a regression model to predict postoperative relapse.Methods The clinical data of 362 patients who underwent cervical conization for cervical HGSIL in the First Affiliated Hospital of Henan University from January 2016 to August 2020 were collected and divided into the relapse group(n=40)and the non-relapse group(n=322)based on the presence or absence of relapse during the follow-up period.The risk factors for postoperative relapse in patients were analyzed using univariate and multivariate analysis,and the predictive model was constructed.The predictive efficacy of the model was assessed by applying the receiver operating characteristic(ROC)curve and the Hosmer-Lemeshow(H-L)Goodness-of-Fit Test.Results Univariate analysis results showed that postoperative relapse was significantly correlated with menopausal status(P=0.006),cutting edge status(P=0.006),and postoperative human papilloma virus(HPV)infection status(P=0.002).Multivariate analysis results showed that pos toperative relapse was independently correlated with m enopausal(P=0.004),positive cutting edge(P=0.003),and the presence of postoperative HPV infection(P=0.002).The result of H-L Goodness-of-Fit Test wasχ^(2)=2.859,P>0.05,and the area under the ROC curve(AUC)was 0.710.Conclusion The constructed regression model can effectively predict the risk of postoperative relapse in patients with cervical HGSIL.

关 键 词：宫颈高级别鳞状上皮内病变 宫颈锥切术 复发 预测模型 

分 类 号：R737.33[医药卫生—肿瘤]