Ⅱ~Ⅲ期左半结肠癌患者根治术后复发的独立危险因素分析及列线图预测模型的建立  

Analysis of Independent Risk Factors for Postoperative Recurrence in Patients with StageⅡ~ⅢLeft Colon Cancer after Radical Surgery and Establishment of a Column Chart Prediction Model

作　　者：罗芳[1] 陈静宜[1] Luofang;Chen Jingyi(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 318050,China)

机构地区：[1]浙江省台州医院,浙江台州318050

出　　处：《医疗装备》2023年第21期8-12,共5页Medical Equipment

摘　　要：目的分析Ⅱ~Ⅲ期左半结肠癌患者根治术后复发的独立危险因素,并构建列线图预测模型。方法回顾性分析2019年6月至2022年6月于医院行根治性切除术的114例Ⅱ~Ⅲ期左半结肠癌患者的临床资料,分析影响患者术后复发的危险因素,并根据危险因素构建列线图预测模型。结果入选的114例Ⅱ~Ⅲ期左半结肠癌患者中,术后复发34例(29.82%)。单因素分析结果显示,肠梗阻、腹腔积液、合并糖尿病、癌胚抗原(CEA)阳性、血管侵犯、N分期是影响左半结肠癌患者术后复发的相关因素(P<0.05)。多因素分析结果显示,腹腔积液、合并糖尿病、CEA阳性、血管侵犯及N分期为N1、N2是左半结肠癌患者术后复发的独立危险因素(P<0.05)。建立列线图预测模型,腹腔积液71分,合并糖尿病62分,CEA阳性80分,血管侵犯84分,N分期为N131分,N分期为N296分。绘制受试者工作特征曲线(ROC),曲线下面积(AUC)为0.851。校准曲线图显示,列线图预测模型具有较好的一致性。结论腹腔积液、合并糖尿病、CEA阳性、血管侵犯及N分期为N1、N2是Ⅱ~Ⅲ期左半结肠癌患者根治术后复发的独立危险因素,以此构建的列线图预测模型有助于评估Ⅱ~Ⅲ期左半结肠癌患者根治术后复发风险。Objective To analyze the independent risk factors for recurrence after radical surgery in patients with stageⅡ-Ⅲleft hemicolectomy and constructs a predictive model of the column line graph.Methods Retrospective analysis of clinical data of 114 patients with stageⅡ-Ⅲleft hemi-colon cancer who underwent radical surgery in Hospital from June 2019 to June 2022.The postoperative recurrence of patients was observed,the factors influencing the postoperative recurrence of patients were analyzed,and a columnar graph prediction model was established.Results Among 114 patients with stageⅡ-Ⅲleft hemi colon cancer,34(29.82%)recurred after surgery,the results of the univariate analysis showed that intestinal obstruction,peritoneal effusion,combined diabetes mellitus,carcinoembryonic antigen(CEA)positive,vascular invasion,and N stage were relevant factors influencing patients'postoperative recurrence(P<0.05).The results of the multifactorial analysis showed that peritoneal effusion,combined diabetes mellitus,CEA positivity,vascular invasion,and N stage of N1 and N2 were independent risk factors for postoperative recurrence in patients(P<0.05).A nomogram prediction model was established,scoring 71 for peritoneal effusion,62 for combined diabetes,80 for positive CEA,84 for vascular invasion,31 for N stage N1,and 96 for N stage N2.The receiver operationcharacteristic curve(ROC)was plotted with an area under curve(AUC)of 0.851.Conclusions Peritoneal effusion,combined diabetes mellitus,positive CEA,vascular invasion,and N stage as N1 and N2 were independent risk factors for recurrence after radical surgery in patients with stageⅡ~Ⅲleft hemi colon cancer.A column-line graphical prediction model constructed in this way contributes to the risk of recurrence after radical surgery in patients with stageⅡ~Ⅲleft-sided colon cancer.

关 键 词：左半结肠癌 根治术 复发 列线图预测模型 

分 类 号：R735.3[医药卫生—肿瘤]