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| 妇科恶性肿瘤术后淋巴漏形成的相关因素分析及构建临床预测模型 |
| Analysis of Related Factors and Construction of a Clinical Prediction Model for Postoperative Lymphorrhea of Gynecological Malignancies |
| 投稿时间：2024-07-17 修订日期：2024-08-24 |
| DOI： |
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| 中文关键词: 妇科恶性肿瘤 淋巴漏 淋巴结清扫术 临床预测模型 |
| 英文关键词:Gynecological malignant tumor Lymphatic leakage Lymph node dissection Lymph node dissection Clinical predictive model |
| 基金项目:编号:宁夏回族自治区卫生健康委研究课题(2023-NWKYP-003)；宁夏自然科学基金资助项目(2023AAC03487)；宁夏回族自治区卫生健康系统科研课题资助项目(2023-NWKYT-006)。 |
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| 摘要点击次数: 185 |
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| 中文摘要: |
| 目的 探讨妇科恶性肿瘤术后淋巴漏发生的相关因素及构建临床预测模型。方法 回顾性分析行淋巴结切除术的507例手术资料,根据术后是否发生淋巴漏分为淋巴漏组(59例)和非淋巴漏组(448例),采用秩和检验和χ2 检验进行单因素分析,用r语言构建多因素logistic临床预测模型及列线图进行临床预测。结果 单因素分析结果显示术前/术后白蛋白、术后前白蛋白、病种、分期、淋巴结数目、术中出血量、术后输注白蛋白、手术方式与术后淋巴漏发生有关,差异有统计学意义(P<0.05)。二元 Logistic 回归模型最终纳入淋巴结数目、术中出血量、术前/术后白蛋白水平、是否患高血压5个变量。训练集构建的模型AUC(95% CI)值为0.808(0.741-0.875),灵敏度81.4％,特异度65.3％,正确指数67％。验证集AUC(95% CI)值0.684(0.552-0.816),灵敏度68.8％,特异度61.0％,正确指数62.2％。结论 妇科恶性肿瘤术后淋巴漏发生相关因素构建的模型对术后淋巴漏发生具有一定预测作用,可为早期干预策略提供依据。 |
| 英文摘要: |
| Objective To explore the related factors of postoperative lymphorrhea of gynecological malignant tumor and construct a clinical prediction model. Methods The clinical data of 507 patients who underwent lymphadenectomy were retrospectively analyzed. Based on whether lymph leakage occurred postoperatively, the patients were divided into lymph leakage group (59 cases) and non-lymph leakage group (448 cases). Univariate analysis was performed using the rank sum test and chi-square test, and a multivariate logistic clinical prediction model and a nomogram were constructed using the R language for clinical prediction. Results The univariate analysis revealed statistically significant associations (P<0.05) between postoperative lymph leakage and factors including preoperative serum albumin level, postoperative serum albumin level, postoperative prealbumin level, disease classification, tumor stage, number of lymph node dissection, intraoperative blood loss, postoperative human serum albumin infusion, and surgical method. The binary logistic regression model ultimately incorporated five variables: the number of lymph nodes, intraoperative blood loss, preoperative serum albumin level, postoperative serum albumin level, and hypertension. The AUC (95% CI) of the model constructed in the training set was 0.808(0.741-0.875), with sensitivity 81.4%, specificity 65.3% and accuracy index 67% while the AUC (95% CI) in the validation set was 0.684 ( 0.552- 0.816), with sensitivity 68.8%, specificity 61.0% and accuracy index 62.2%. Conclusion The model constructed based on the factors related to the occurrence of lymph leak after gynecological malignant tumor surgery has a predictive value for the postoperative lymphorrhagia, thus providing references for early intervention strategies. |
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