结肠癌患者淋巴结转移预测模型的建立  

Establishment of a nomogram model for lymph node metastasis in colon cancer patients

作　　者：徐伯麒 陶亮 章帆 毛忠琦[1] Xu Boqi;Tao Liang;Zhang Fan;Mao Zhongqi(Department of General Surgery,The First Affiliated Hospital of Soochow University,Suzhou Jiangsu Province 215000,China)

机构地区：[1]苏州大学附属第一医院普外科,江苏苏州215000

出　　处：《中华普外科手术学杂志（电子版）》2023年第4期393-397,共5页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金青年基金项目(81500482);江苏省自然科学基金青年项目(BK20150105);江苏省博士后基金(1501121B)。

摘　　要：目的分析结肠癌患者淋巴结转移的危险因素,构建列线图模型。方法回顾性分析2020年04月至2021年09月319例接受结肠癌根治术的患者临床资料,运用统计学软件SPSS 22.0进行数据分析,通过卡方检验或Fisher精确检验对结肠癌淋巴结转移可能相关的危险因素进行单因素分析,将所有P<0.100的变量筛选出来,进一步进行多因素Logistic回归分析,筛选出独立危险因素并建立列线图模型。通过绘制受试者工作特征曲线与校准曲线评估列线图模型的预测性能。采用Bootstrap法对模型进行内部验证。采用DCA曲线验证模型的临床获益度。结果150例患者(47.0%)发生了淋巴结转移,多因素Logistic回归分析显示,浸润深度T_(3-4)(OR=14.119,P=0.011)、有脉管侵犯(OR=3.551,P=0.008)、癌胚抗原>5.0 ng/ml(OR=1.985,P=0.010)、糖类抗原199>37.0 U/ml(OR=5.310,P=0.000)是结肠癌患者淋巴结转移的独立危险因素。结论基于独立危险因素建立的列线图模型对预测结肠癌患者淋巴结转移具有良好的敏感性和特异性,具备一定的临床价值。Objective To predict the risk factors of lymph node metastasis in patients with colon cancer,a nomogram model was establishedM.ethodsA total of 319 patients who received surgery for colon cancer in The First Affiliated Hospital of Soochow University from April 2020 to September 2021 were included.Based on the association strength of univariate and multiple Logistic regressions,the potential risk factors for lymph node metastasis were identified from the characteristic variables,and then a Nomogram model was generated.The Receiver Operating Characteristic Curve was used to evaluated the prediction performance of this nomogram model.This nomogram model was validated and calibrated using Bootstrap method.The model was also evaluated for clinical significance using the Decision Curve Analysis curve.ResultsAmong 319 colon cancer patients,lymph metastasis occurred in 150 patients(47%).The multiple logistic regressions showed that the depth of invasion(OR=14.119,P=0.011),vascular invasion(OR=3.551,P=0.008),Carcinogenic Embryonic Antigen>5.0 ng/ml(OR=1.985,P=0.010),and Carbohydrate antigen199>37.0 U/ml(OR=5.310,P=0.000)were independent risk factors for lymph node metastasis in colon cancer patients.Conclusion The nomogram based on independent risk factors identified from our method showed a good performance in predicting lymph node metastasis in colon cancer.

关 键 词：结肠肿瘤 列线图 预测模型 

分 类 号：R735.34[医药卫生—肿瘤]