肉芽肿性小叶性乳腺炎患者术后复发风险列线图预测模型的构建与验证  

Construction and Validation of A Nomogram Prediction Model for Postoperative Recurrence Risk in Patients with Granulomatous Lobular Mastitis

作　　者：艾尼·沙塔尔[1] 张卫群[1] 阿力木江·吾普尔 波拉提·沙依提[1] 王胄 丁伟[1] Aini·Shatar;ZHANG Wei-qun;Alimujiang·Wupur;Bolati·Shayiti;WANG Zhou;DING Wei(Department of Thyroid and Breast,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang,830000,China)

机构地区：[1]新疆维吾尔自治区人民医院甲乳科,新疆乌鲁木齐830000

出　　处：《现代生物医学进展》2025年第5期893-900,共8页Progress in Modern Biomedicine

基　　金：新疆维吾尔自治区自然科学基金项目(2019D01C196);新疆维吾尔自治区人民医院院内项目(20200308)。

摘　　要：目的:探讨肉芽肿性小叶性乳腺炎(GLM)患者术后复发的独立影响因素,构建术后复发的列线图预测模型并实施验证。方法:选择2020年1月至2023年12月期间在我院接受手术治疗的181例GLM患者,依据术后复发情况实施分组,分为复发组(24例)以及未复发组(157例)。多因素Logistic回归分析术后复发的因素,同时构建列线图模型,分析列线图模型的预测价值并进行验证。结果:181例GLM患者术后有24例患者复发,复发率为13.26%。单因素分析结果显示,GLM患者术后复发与瘘管或窦道、脓肿形成、体重指数(BMI)、治疗方案、病程、泌乳素(PRL)、雌二醇(E_(2))有关(P<0.05)。多因素条件Logistic回归分析结果显示BMI偏高、治疗方案为单纯手术、PRL偏高、E_(2)偏高、脓肿形成是复发的危险因素(P<0.05)。术后复发风险列线图显示:5个因素的总分为310分,脓肿形成是最重要的因素,得分为100分。受试者工作特征(ROC)曲线分析显示:该列线图模型对术后复发预测效能较高,AUC(95%CI)为0.850(0.734~0.961)。校准曲线可见预测概率与实际概率大体一致,且Hosmer-Lemeshow拟合优度检验(χ^(2)=8.581,P=0.379),一致性较好。结论:BMI偏高、治疗方案为单纯手术、PRL偏高、E_(2)偏高、脓肿形成是GLM患者术后复发风险的危险因素,利用这些因素构建的列线图模型对术后复发具有较好的预测价值,该列线图模型具备良好的校准度。Objective:To explore the independent influencing factors of postoperative recurrence in patients with granulomatous lobular mastitis(GLM),to construct a nomogram prediction model for postoperative recurrence and implement verification.Methods:181 GLM patients who underwent surgical treatment in our hospital from January 2020 to December 2023 were analyzed,group was grouped according to postoperative recurrence,patients were divided into recurrence group(24 cases)and non-recurrence group(157 cases).The factors of postoperative recurrence were analyzed by multivariate Logistic regression analysis,and a nomogram model was constructed,to analyze the predictive value of the nomogram model and verify it.Results:There were 24 cases postoperative recurrence in 181 GLM patients,with a recurrence rate of 13.26%.Univariate analysis showed that,postoperative recurrence of GLM patients was related to fistula or sinus tract,abscess formation,body mass index(BMI),treatment plan,course of disease,prolactin(PRL)and estradiol(E_(2))(P<0.05).Multivariate conditional Logistic regression analysis showed that high BMI,treatment plan was simple surgery,high PRL,high E_(2) and abscess formation were risk factors for recurrence(P<0.05).The postoperative recurrence risk nomogram showed that:the total score of the five factors was 310 points,and abscess formation was the most important factor,with a score of 100 points.Receiver operating characteristic(ROC)curve analysis showed that:the nomogram model had a high predictive efficiency for postoperative recurrence,with an AUC(95%CI)of 0.850(0.734~0.961).The calibration curve showed that the predicted probability was generally consistent with the actual probability,and the Hosmer-Lemeshow goodness of fit test(χ^(2)=8.581,P=0.379),showed good consistency.Conclusion:High BMI,treatment plan is simple surgery,high PRL,high E_(2) and abscess formation are risk factors for postoperative recurrence risk in GLM patients.The column chart model constructed using these factors has good predictive value

关 键 词：肉芽肿性小叶性乳腺炎 复发 列线图 预测模型 构建 验证 

分 类 号：R3[医药卫生—基础医学] R655.8