绝经后Ⅰ型子宫内膜癌高危因素分析及预测模型的建立  

Analysis of risk factors and establishment of a prediction model for postmenopausal type I endometrial carcinoma

作　　者：田莉 金梦瑶 丁永慧[1] TIAN Li;JIN Mengyao;DING Yonghui(Department of Gynecology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;School of Clinical Medicine,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院妇科,宁夏银川750004 [2]宁夏医科大学临床医学院,宁夏银川750004

出　　处：《宁夏医学杂志》2025年第3期217-221,F0003,共6页Ningxia Medical Journal

基　　金：宁夏科技惠民专项项目(2022CMG03019);宁夏重点研发计划项目(2019BEH03005)。

摘　　要：目的探讨绝经后女性罹患Ⅰ型子宫内膜癌的高危因素并建立预测模型。方法收集绝经后Ⅰ型子宫内膜癌及正常子宫内膜疾病组各150例患者作为研究对象,并对患者的临床相关因素进行回顾性分析,分析各相关因素与Ⅰ型子宫内膜癌的关系。采用单因素、多因素logisitic回归分析筛选出Ⅰ型子宫内膜癌的相关因素,并通过R语言建立Ⅰ型子宫内膜癌发生风险的预测模型。结果患者月经不规律、合并高血压及糖尿病是子宫内膜癌发病的危险因素(P<0.05);身体质量指数(BMI)<24 kg/m 2、孕次是绝经后女性Ⅰ型子宫内膜癌发病的保护因素(P<0.05)。基于上述风险因素,构建绝经后Ⅰ型子宫内膜癌的预测模型,通过训练集与验证集全面检验模型的预测效能,受试者工作特征(ROC)曲线下面积(AUC)分别为0.78、0.72,校准曲线的斜率近乎1,曲线与45°线有较好的拟合,模型预测的绝经后Ⅰ型子宫内膜癌发生概率与实际情况之间存在较好的一致性,预测模型和实际诊断比较差异无统计学意义(P>0.05)。结论绝经后Ⅰ型子宫内膜癌发生与肥胖女性、合并高血压及糖尿病女性有关,绝经前月经紊乱是Ⅰ型子宫内膜癌发生的高危因素之一,由此建立的绝经后Ⅰ型子宫内膜癌列线图预测模型具有较强的预测能力。Objective To investigate the risk factors of type I endometrial cancer in postmenopausal women and to establish a prediction model.Methods 150 patients with postmenopausal type I endometrial cancer and normal endometrial group each were collected as study subjects,and the clinical correlates of the patients were retrospectively analyzed the relationship between different correlates and type I endometrial cancer.The related factors of type I endometrial cancer,and a prediction model of type I endometrial cancer risk was established by R language.Results Irregular menstruation,hypertension and diabetes were the risk factors of endometrial carcinoma in patients(P<0.05).BMI<24 kg/m 2 and pregnancy number were the protective factors for the incidence of endometrial cancer of postmenopausal type I(P<0.05),and based on the above risk factors,the prediction model of endometrial cancer of postmenopausal type I was constructed.The area under the curve(AUC)of the subjects in the training set and verification set of the prediction model were 0.78 and 0.72,respectively.The slope of the calibration curve was approximately 1,and the curve had a good fit with the 45-degree line,and there was a good agreement between the probability of postmenopausal type I endometrial cancer predicted by the model and the actual situation,and there was no discrepancy between the prediction model and the actual diagnosis(P>0.05).Conclusion Postmenopausal type I endometrial cancer occurrence is associated with obese women,women with comorbid hypertension and diabetes mellitus,and premenopausal disorders are one of the high-risk factors for the occurrence of type I EC,which led to the development of a postmenopausal type I endometrial cancer nomogram prediction model with strong predictive ability.

关 键 词：Ⅰ型子宫内膜癌 相关因素 预测模型 

分 类 号：R711[医药卫生—妇产科学]