同时性多原发结直肠癌和单发结直肠癌鉴别因素列线图模型的构建  

A nomogram model for distinguishing factors of synchronous multiple colorectal carcinoma from single colorectal carcinoma

作　　者：程晋坤 李琪 崔巍[1] CHENG Jinkun;LI Qi;CUI Wei(Department of Colorectal Surgery,Ningbo Medical Center Lihuili Hospital,Ningbo 315041,China)

机构地区：[1]宁波市医疗中心李惠利医院结直肠外科,浙江宁波315041

出　　处：《温州医科大学学报》2023年第12期980-984,共5页Journal of Wenzhou Medical University

基　　金：浙江省医药卫生科技计划项目(2023KY1027)。

摘　　要：目的:探讨鉴别同时性多原发结直肠癌(SMCRC)和单发结直肠癌(单发CRC)发生的相关因素,构建列线图预测模型。方法:回顾性收集2016年1月至2021年12月于宁波市医疗中心李惠利医院行手术治疗的42例SMCRC及120例单发CRC患者的临床资料,经单因素分析和多因素Logistic回归分析鉴别SMCRC和单发CRC发生的相关因素,据此构建列线图预测模型,ROC曲线与校准曲线分析该模型的预测效能。结果:单因素分析显示,性别、合并腺瘤性息肉、高血压、血清癌胚抗原水平、白蛋白含量、血红蛋白含量在两组间差异有统计学意义(P<0.05);多因素Logistic回归分析显示男性(OR=3.108,95%CI=1.113~8.682)、合并腺瘤性息肉(OR=2.941,95%CI=1.036~8.346)、高血压(OR=3.202,95%CI=1.128~9.088)、血红蛋白≤120 g/L(OR=3.868,95%CI=1.095~13.671)是SMCRC发生的独立预测因素(P<0.05)。将男性、合并腺瘤性息肉、高血压、血红蛋白≤120 g/L作为预测因子,绘制列线图模型,模型的ROC曲线下面积为0.743(95%CI=0.630~0.856),灵敏度为75%,特异度为68%。校准曲线显示3条曲线拟合度良好,提示本模型具有较好的一致性和准确性。结论:男性、合并腺瘤性息肉、高血压、血红蛋白≤120 g/L是鉴别SMCRC和单发CRC发生的相关因素,构建的列线图预测模型可较准确评估SMCRC的存在风险,为临床早期识别SMCRC提供依据。Objective:To explore the differentiation factors related to the synchronous multiple colorectal carcinoma(SMCRC)and single colorectal carcinoma(CRC),and to construct a nomogram prediction model.Methods:The clinical data of 42 patients with SMCRC and 120 patients with single CRC who underwent surgery in Ningbo Medical Center Lihuili Hospital from January 2016 to December 2021 were retrospectively collected.Univariate analysis and multivariate Logistic regression were used to analyze the differentiation factors related to the SMCRC and single CRC,based on which a nomogram prediction model was constructed.The predictive efficiency of the model was analyzed by ROC curve and calibration curve.Results:Univariate analysis showed that sex,adenomatous polyp,hypertension,serum carcinoembryonic antigen level,albumin content,and hemoglobin content were statistically difference between the two groups(P<0.05).Multivariate Logistic regression analysis showed that male(OR=3.108,95%CI=1.113-8.682),adenomatous polyp(OR=2.941,95%CI=1.036-8.346),hypertension(OR=3.202,95%CI=1.128-9.088),and hemoglobin≤120 g/L(OR=3.868,95%CI=1.095-13.671)were independent predictors for distinguishing the occurrence of SMCRC from single CRC(P<0.05).The area under the ROC curve was 0.743(95%CI=0.630-0.856).The sensitivity was 75%and the specificity was 68%.The calibration curve showed that the three curves fit well,indicating that the model had good consistency and accuracy.Conclusion:In this study,the identification factors related to SMCRC and single CRC has been analyzed and a nomogram prediction model constructed to accurately assess the risk of SMCRC,which provides a basis for early clinical identification of SMCRC.

关 键 词：同时性 多原发结直肠癌 单发结直肠癌 列线图 

分 类 号：R735.3[医药卫生—肿瘤]