摘要
目的探讨早期食管癌内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)后并发食管狭窄的危险因素,建立列线图风险预测模型。方法回顾性分析2018年1月至2022年12月在南京大学医学院附属鼓楼医院和南京市高淳人民医院消化内科行ESD治疗的921例早期食管癌患者相关资料,采用单因素和多因素Logistic回归分析筛选,通过R软件建立列线图预测模型并进行验证。结果吸烟、饮酒、喜食腌制食物、喜食辛辣食物、喜食滚烫食物、血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)<100,环周比例<1/2均显著影响早期食管癌ESD术后发生食管狭窄(P<0.05),基于此建立列线图预测模型,受试者工作特性曲线(receiver operator characteristic curve,ROC)的曲线下面积为0.892(95%CI:0.845~0.938),显示模型区分度较好,临床预测模型校准曲线显示模型精准度较好。结论本研究中的列线图预测效果较好,有利于临床直观判断早期食管癌患者ESD术后并发食管狭窄风险率,为早期干预提供参考。
Objective To investigate the risk factors of postoperative esophageal stenosis in patients with early esophageal cancer undergoing endoscopic submucosal dissection(ESD),and to establish a risk prediction model based on a graph.Method The data of 921 patients with early esophageal cancer who received ESD treatment in the Department of Gastroenterology,Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School and Nanjing Gaochun People's Hospital from January 2018 to December 2022 were retrospectively analyzed.Univariate and multifactor Logistic regression analysis was used for screening.The prediction model of line graph was constructed and verified by R software.Result Smoking,drinking,like pickled food,like spicy food,like hot food,platelet to lymphocyte ratio(PLR)<100,circumferential ratio<1/2 were the factors influencing esophageal stenosis after ESD operation for early esophageal cancer(P<0.05).A Calibration curve model was established based on these 7 independent factors.The area under receiver operator characteristic curve(ROC)was 0.892(95%CI:0.845-0.938),and the calibration curve showed better model differentiation.Conclusion The column graph prediction model constructed in this study has a good prediction effect,which is conducive to the clinical intuitive judgment of the risk rate of postoperative esophageal stenosis in patients with early esophageal cancer undergoing ESD,and provides reference for early intervention.
作者
滕玉芳
杨华
徐桂芳
于铃
陈亚楠
Teng Yufang;Yang Hua;Xu Guifang;Yu Ling;Chen Yanan(Department of Gastroenterology,Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China;Department of Gastroenterology,Nanjing Gaochun People’s Hospital,Nanjing 210008,Jiangsu,China)
出处
《消化肿瘤杂志（电子版）》
2023年第3期215-221,共7页
Journal of Digestive Oncology(Electronic Version)
基金
国家自然科学基金资助项目(82170548)。
关键词
早期食管癌
内镜黏膜下剥离术
食管狭窄
列线图
Early esophageal carcinoma
Endoscopic submucosal dissection
Esophageal stenosis
Column diagram
作者简介
通信作者:杨华,nissan3600@163.com。
