| 盖晋维,车金超,恩日乐图.术前使用列线图预测胃癌患者淋巴结转移[J].肿瘤学杂志,2021,27(12):1022-1027. |
| 术前使用列线图预测胃癌患者淋巴结转移 |
| Development of a Nomogram for Preoperative Prediction of Lymph Node Metastasis in Gastric Cancer Patients |
| 中文关键词 |
| DOI：10.11735/j.issn.1671-170X.2021.12.B010 |
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| 中文关键词: 胃肿瘤 淋巴结转移 临床预测模型 列线图 |
| 英文关键词:gastric cancer lymph node metastasis clinical prediction model nomogram |
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| 中文摘要: |
| 摘 要：［目的］ 拟构建列线图预测术前胃癌淋巴结转移情况。［方法］ 回顾性分析接受胃癌根治术患者170例，按照病理结果将患者分为淋巴结转移组110例和无淋巴结转移组60例。采用Logistic回归分析筛选出胃癌淋巴结转移的独立危险因素，建立预测模型，并用1 000个bootstrap样本进行校正以减少过拟合偏差。［结果］ 通过单因素和多因素Logistic回归分析，显示与胃癌淋巴结转移相关的因素有CA72-4、PLR、CT影像学T分期、N分期，结合这4个因素构建的列线图在预测胃癌淋巴结转移风险方面表现出良好的准确性，C统计量为 0.87（95% CI：0.81～0.93），内部验证校正后的C统计量为0.86，具有良好的拟合校准曲线。当列线图评分≥110分的胃癌患者高度怀疑有淋巴结转移。［结论］ 列线图提供了较准确的胃癌患者术前淋巴结转移预测。 |
| 英文摘要: |
| Abstract： ［Objective］ To develop a nomogram for preoperative prediction of lymph node metastasis in gastric cancer patients. ［Methods］ Clinical data of 170 gastric cancer patients undergoing radical gastrectomy were retrospectively analyzed， including 110 cases with lymph node metastasis(metastasis group) and 60 cases without lymph node metastasis(non-metastasis group). Logistic regression analysis was used to determine independent risk factors for lymph node metastasis of gastric cancer， and a prediction nomogram was developed； and 1 000 bootstrap samples were used for correction to reduce over fitting deviation. ［Results］ Multivariate logistic regression analysis showed that CA72-4(OR=3.35， 95%CL： 1.14~10.98， P<0.05)， PLR(OR=4.08， 95%CI： 1.67~10.81， P<0.05)， cT(OR=3.07， 95%CI： 2.00~5.04， P<0.05)， cN(OR=2.62， 95%CI： 1.50~4.91， P<0.05)were independent risk factors of lymph node metastasis in gastric cancer. On the bases of risk factors a nomogram was developed， The C statistic of the nomogram was 0.87(95%CI： 0.81～0.93)， after internal verification and correction it was 0.86， and had a good fitting calibration curves. Gastric cancer patients with the score of 110 or greater were highly suspected of having lymph node metastasis. ［Conclusion］ The nomogram developed in the study provides accurate preoperative prediction of lymph node metastasis in gastric cancer patients. |
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