HPGC Research Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
BMC Gastroenterol. 2024 Jan 18;24(1):39. doi: 10.1186/s12876-024-03123-z.
Gastric cancer (GC) is considered a silent killer, taking more than three quarters of a million lives annually. Therefore, prior to further costly and invasive diagnostic approaches, an initial GC risk screening is desperately in demand.
In order to develop a simple risk scoring system, the demographic and lifestyle indices from 858 GC and 1132 non-ulcer dyspeptic (NUD) patients were analysed. We applied a multivariate logistic regression approach to identify the association between our target predictors and GC versus NUD. The model performance in classification was assessed by receiver operating characteristic (ROC) analysis. Our questionnaire covering 64 predictors, included known risk factors, such as demographic features, dietary habits, self-reported medical status, narcotics use, and SES indicators.
Our model segregated GC from NUD patients with the sensitivity, specificity, and accuracy rates of 85.89, 63.9, and 73.03%, respectively, which was confirmed in the development dataset (AUC equal to 86.37%, P < 0.0001). Predictors which contributed most to our GC risk calculator, based on risk scores (RS) and shared percentages (SP), included: 1) older age group [> 70 (RS:+ 241, SP:7.23), 60-70 (RS:+ 221, SP:6.60), 50-60 (RS:+ 134, SP:4.02), 2) history of gastrointestinal cancers (RS:+ 173, SP:5.19), 3) male gender (RS:+ 119, SP:3.55), 4) non-Fars ethnicity (RS:+ 89, SP:2.66), 5) illiteracy of both parents (RS:+ 78, SP:2.38), 6) rural residence (RS:+ 77, SP:2.3), and modifiable dietary behaviors (RS:+ 32 to + 53, SP:0.96 to 1.58).
Our developed risk calculator provides a primary screening step, prior to the subsequent costly and invasive measures. Furthermore, public awareness regarding modifiable risk predictors may encourage and promote lifestyle adjustments and healthy behaviours.
胃癌（GC）被认为是“沉默的杀手”，每年夺走超过 75 万人的生命。因此，在进行进一步昂贵且有创的诊断方法之前，迫切需要进行初步的 GC 风险筛查。
为了开发一个简单的风险评分系统，我们分析了 858 例 GC 和 1132 例非溃疡性消化不良（NUD）患者的人口统计学和生活方式指标。我们应用多变量逻辑回归方法来确定目标预测因子与 GC 与 NUD 之间的关联。通过接收者操作特征（ROC）分析评估模型在分类中的性能。我们的问卷涵盖了 64 个预测因子，包括已知的危险因素，如人口统计学特征、饮食习惯、自我报告的健康状况、麻醉品使用和 SES 指标。
我们的模型将 GC 与 NUD 患者区分开来，其灵敏度、特异性和准确率分别为 85.89%、63.9%和 73.03%，这在开发数据集（AUC 等于 86.37%，P<0.0001）中得到了验证。基于风险评分（RS）和共享百分比（SP），对我们的 GC 风险计算器贡献最大的预测因子包括：1）年龄较大组（>70 岁[RS：+241，SP：7.23]，60-70 岁[RS：+221，SP：6.60]，50-60 岁[RS：+134，SP：4.02]），2）胃肠道癌症史（RS：+173，SP：5.19），3）男性（RS：+119，SP：3.55），4）非法尔斯族裔（RS：+89，SP：2.66），5）父母均文盲（RS：+78，SP：2.38），6）农村居住（RS：+77，SP：2.3）和可改变的饮食行为（RS：+32 至+53，SP：0.96 至 1.58）。
我们开发的风险计算器提供了一个初步的筛选步骤，然后再进行后续昂贵且有创的措施。此外，公众对可改变的风险预测因子的认识可能会鼓励和促进生活方式的调整和健康行为。
