基于决策树法构建老年肝细胞癌患者TACE术后急性中重度腹痛的风险预测模型  

Based on the decision tree method,a risk prediction model for acute moderate to severe abdominal pain in elderly patients with hepatocellular carcinoma after TACE was constructed

作　　者：卢慧[1] 张姬[1] 李玮玮[1] Lu Hui;Zhang Ji;Li Weiwei(Department of Intervention,Nantong Third People's Hospital,Nantong 226000,China)

机构地区：[1]南通市第三人民医院介入科,226000

出　　处：《中华保健医学杂志》2025年第1期89-93,共5页Chinese Journal of Health Care and Medicine

基　　金：江苏省南通市自然科学基金和社会民生科技计划(指导性)项目(MSZ2023226)。

摘　　要：目的基于决策树法构建老年肝细胞癌(HCC)患者经动脉化疗栓塞(TACE)术后急性中重度腹痛的风险预测模型,为预防患者TACE术后急性中重度腹痛提供参考。方法回顾性收集2020年10月~2023年9月期间在南通市第三人民医院介入科接受TACE治疗的362例老年HCC患者的临床资料。根据术后48 h内是否发生急性中重度腹痛,将患者分为腹痛组(n=123)和无腹痛组(n=239)。使用决策分类回归树(CRT)法构建急性中重度腹痛的预测模型,并通过受试者工作特征(ROC)曲线分析比较预测效果。结果单因素分析结果显示,两组患者在TACE手术史、肿瘤距肝包膜距离、肿瘤最大直径、肿瘤数目、血管侵犯比例、TACE术式、TACE术后腹痛病史、碘油用量和使用无水乙醇比例方面差异具有统计学意义(χ^(2)=18.772、24.295、32.255、19.708、35.844、32.496、8.719、107.524、62.734,P<0.05)。CRT模型构建结果显示,碘油用量、是否使用无水乙醇、血管侵犯、TACE手术史、TACE术式及肿瘤数目均为术后急性中重度腹痛的影响因素(P<0.05)。CRT模型的曲线下面积(AUC)为0.895,95%CI=0.858~0.932,灵敏度为0.772,特异度为0.912。结论老年HCC患者术后发生急性中重度腹痛的主要影响因素包括碘油用量、是否使用无水乙醇、血管侵犯情况、TACE手术史、TACE术式及肿瘤数目。基于上述因素构建的CRT模型具有良好的预测效果。Objective Based on the decision tree method,a risk prediction model for acute moderate to severe abdominal pain after transarterial chemoembolization(TACE)in elderly patients with hepatocellular carcinoma(HCC)was constructed to provide a reference for the prevention of such pain after TACE.Methods A total of 362 elderly patients with HCC who underwent TACE at the interventional department of Nantong Third People's Hospital from October 2020 to September 2023 were retrospectively selected for this study.Patients were divided into two groups based on the occurrence of acute moderate to severe abdominal pain within 48 hours post-operation:the abdominal pain group(n=123)and the non-abdominal pain group(n=239).SPSS software was used to construct a prediction model for postoperative acute moderate to severe abdominal pain based on Classification and Regression Tree(CRT).The predictive value was analyzed by comparing the Receiver Operating Characteristic(ROC)curve.Results Univariate analysis showed statistically significant differences between the two groups in terms of TACE surgery history,tumor distance from the liver capsule,maximum tumor diameter,tumor number,vascular invasion,TACE procedure,history of abdominal pain after TACE,lipidol volume,and the use of anhydrous ethanol(χ^(2)=18.772,24.295,32.255,19.708,35.844,32.496,8.719,107.524,62.734,P<0.05).CRT model construction indicated that lipidol volume,use of anhydrous ethanol,vascular invasion,TACE surgery history,TACE procedure type,and tumor number were significant risk factors for acute moderate to severe abdominal pain in elderly patients with HCC after TACE(P<0.05).The area under the curve(AUC)of the CRT model was 0.895(95%CI=0.858~0.932),with sensitivity of 0.772 and specificity of 0.912.Conclusion The risk factors for postoperative acute moderate to severe abdominal pain in elderly HCC patients include lipidol volume,use of anhydrous ethanol,vascular invasion,history of TACE surgery,TACE procedure type,and tumor number.The CRT model based on these factors s

关 键 词：决策分类回归树 老年肝细胞癌患者 经动脉化疗栓塞 急性中重度腹痛 

分 类 号：R735.7[医药卫生—肿瘤]