摘要
目的分析子宫内膜癌患者术后下肢深静脉血栓(DVT)发生的影响因素,建立列线图预警模型。方法将683例子宫内膜癌手术患者按照7∶3比例分为建模队列与验证队列,采用单因素与多因素Logistic回归模型分析术后下肢DVT发生的危险因素,建立列线图预警模型并进行验证。结果建模队列术后下肢DVT发生率为7.95%(38/478),验证队列术后下肢DVT发生率为8.29%(17/205)。多因素Logistic分析显示,体重指数﹥28 kg/m^(2)、合并糖尿病+高血压、肿瘤国际妇产科联盟(FIGO)分期为Ⅲ期、血小板计数﹥300×10^(9)/L、D-二聚体升高值﹥1 mg/L均是术后下肢DVT发生的独立危险因素(P﹤0.05)。建立预测子宫内膜癌患者术后下肢DVT风险的列线图模型,列线图预测术后下肢DVT发生风险的C-index为0.866,建模队列与验证队列曲线下面积(AUC)分别为0.859、0.810,校准曲线斜率均接近1,决策曲线分析(DCA)阈概率范围分别为0.08~0.60、0.10~0.48,模型表现为正的净收益。结论本研究构建的子宫内膜癌术后下肢DVT列线图预警模型可直观预测术后下肢DVT发生风险,能够为临床预防性干预措施的制订提供一定参考价值。
Objective To analyze the influencing factors that affect deep vein thrombosis(DVT)in patients with en‐dometrial cancer after surgery,and establish a nomogram warning model.Method A total of 683 patients undergoing en‐dometrial cancer surgery were divided into modeling cohort and verification cohort according to a 7∶3 ratio,univariate and multivariate Logistic regression model were used to analyze the risk factors affecting postoperative DVT in the lower limbs,to establish and verify the nomogram warning model.Result The incidences of DVT in the lower limbs of the modeling cohort and verification cohort were 7.95%(38/478)and 8.29%(17/205),respectively;multivariate Logistic analysis showed that body mass index(BMI)>28 kg/m^(2),concomitant diabetes+hypertension,tumor International Federa‐tion of Gynecology and Obstetrics(FIGO)stage III,platelet count>300×10^(9)/L,D-dimer value added>1 mg/L were inde‐pendent risk factors for lower limbs DVT after operation(P<0.05).The nomogram model was established with indepen‐dent predictors,the C-index of the nomogram to predict the risk of postoperative lower limbs DVT was 0.866,and the ar‐ea under the curve(AUC)of the modeling cohort and the verification cohort were 0.859 and 0.810,respectively.The slopes of the calibration curves were all close to 1,and the decision curve analysis(DCA)threshold probability ranges were 0.08-0.60 and 0.10-0.48 respectively,and the model showed a positive net benefit.Conclusion The warning model of lower limbs DVT nomogram after endometrial cancer surgery in the study can intuitively predict the risk of postopera‐tive lower limbs DVT,which can provide reference for the formulation of clinical preventive intervention.
作者
杨倩雯
万媛
刘荣华
毛莉华
YANG Qianwen;WAN Yuan;LIU Ronghua;MAO Lihua(Department of Rheumatology,Northern Division of Huashan Hospital,Fudan University,Shanghai 201906,China)
出处
《癌症进展》
2023年第3期277-282,共6页
Oncology Progress
关键词
子宫内膜癌
下肢深静脉血栓
危险因素
预警模型
列线图
endometrial cancer
deep vein thrombosis of lower limb
risk factor
warning model
nomogram
作者简介
通信作者:毛莉华,邮箱:104239116@qq.com。
