结直肠癌化疗耐药的影响因素分析及其风险预测列线图模型构建  

Influencing factors of chemotherapy resistance of colorectal cancer and construction of nomogram model for risk prediction

作　　者：文雅星 郭忠聪[1] WEN Yaxing;GUO Zhongcong(The First Hospital of Hunan University of Chinese Medicine,Changsha 410000,China)

机构地区：[1]湖南中医药大学第一附属医院,长沙市410000

出　　处：《临床合理用药》2025年第9期27-30,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：湖南省科技创新计划项目(2024JJ9417)。

摘　　要：目的探讨结直肠癌化疗耐药的影响因素,并构建其风险预测列线图模型,以期为临床诊疗提供参考依据。方法回顾性分析2021年1月—2024年12月于湖南中医药大学第一附属医院接受化疗的结直肠癌患者73例的临床资料,根据患者是否耐药分为耐药组21例与非耐药组52例。收集患者临床资料,包括性别、年龄、病理类型、分化程度、TNM分期、中医辨证分型及血清癌胚抗原(CEA)、糖类抗原(CA)19-9、CA72-4水平。结直肠癌化疗耐药影响因素分析采用多因素Logistic回归分析;基于多因素Logistic回归分析结果构建结直肠癌化疗耐药的预测模型,采用校正曲线和受试者工作特征(ROC)曲线评价列线图模型对结直肠癌化疗耐药的预测价值。结果2组分化程度、TNM分期、中医辨证分型及CEA>5 ng/ml占比、CA19-9>35 U/ml占比、CA72-4>6.9 U/ml占比比较,差异有统计意义(P<0.01)。多因素Logistic回归分析结果显示,分化程度、TNM分期、中医辨证分型、CEA、CA19-9、CA72-4是结直肠癌化疗耐药的影响因素(P<0.05或P<0.01)。基于多因素Logistic回归分析结果构建结直肠癌化疗耐药的风险预测列线图模型,得出风险值为0.72。该预测模型预测结直肠癌化疗耐药的建模集ROC曲线下面积(AUC)为0.781,验证集AUC为0.766。结论分化程度、TNM分期、中医辨证分型、CEA、CA19-9、CA72-4是结直肠癌化疗耐药的影响因素,而基于上述影响因素构建的预测模型对结直肠癌化疗耐药的预测价值较高。Objective To explore the influencing factors of chemotherapy resistance of colorectal cancer,and to construct a nomogram model for risk prediction,so as to provide reference for clinical diagnosis and treatment.Methods The clinical data of 73 colorectal cancer patients who received chemotherapy at the First Hospital of Hunan University of Chinese Medicine from January 2021 to December 2024 were retrospectively analyzed,and the patients were divided into 21 cases in the drug-resistant group and 52 cases in the non-resistant group according to whether they were drug-resistant or not.Clinical data of patients were collected,including gender,age,pathological type,degree of differentiation,TNM staging,Chinese medicine identification and typing,and serum CEA,CA19-9,and CA72-4 levels.Analysis of factors influencing chemotherapy resistance in colorectal cancer using multifactorial logistic regression analysis;A predictive model for chemotherapy resistance in colorectal cancer was constructed based on the results of multifactorial logistic regression analysis,and the predictive value of the column chart model for chemotherapy resistance in colorectal cancer was evaluated using calibration curves and subject work characteristics(ROC)curves.Results The differentiation degree,TNM staging,TCM syndrome differentiation and the proportion of CEA>5 ng/ml,CA19-9>35 U/ml and CA72-4>6.9 U/ml between the two groups were statistically significant(P<0.01).The results of multifactorial logistic regression analysis showed that the degree of differentiation,TNM staging,Chinese medicine identification and typing,CEA,CA19-9 and CA72-4 were the influencing factors of chemotherapy resistance in colorectal cancer(P<0.05 or P<0.01).Based on the results of multifactorial logistic regression analysis to construct a risk prediction column plot model for chemotherapy resistance in colorectal cancer,the risk value is 0.72.The prediction model predicted chemotherapy resistance in colorectal cancer with a modeling set AUC of 0.781 and a validation set

关 键 词：结直肠癌 化疗 耐药 影响因素 风险预测模型 肿瘤标志物 中医辨证分型 

分 类 号：R73[医药卫生—肿瘤]