Xi'an Medical University, Xi'an, 710068, China.
Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
J Robot Surg. 2024 Apr 13;18(1):172. doi: 10.1007/s11701-024-01915-9.
The purpose of this research was to investigate the potential predictive value of preoperative systemic inflammatory indexes in identifying lymph node metastasis among patients diagnosed with small bowel cancer. A retrospective analysis of clinical data was conducted on small bowel cancer patients who underwent surgical treatment at the gastrointestinal surgery department of our hospital between January 2010 and June 2021. Patients were divided into groups based on the presence or absence of lymph node metastasis as confirmed by postoperative pathological results. The study compared the differences in preoperative inflammatory indexes and clinical data between the two groups using single factor analysis and multifactorial Logistic regression analysis. Furthermore, a nomogram model for predicting lymph node metastasis in colorectal cancer was constructed using R software and internally validated. The study sample consisted of 140 small bowel cancer patients,postoperative pathology confirmed lymph node metastasis in 72 cases. Univariate analysis results indicated associations between preoperative inflammatory indexes and clinical data with lymph node metastasis in small bowel cancer. Multifactorial logistic regression analysis revealed that gender, PLR, number of lymph node dissection, and lymphovascular invasion independently influenced lymph node metastasis in small bowel cancer patients. The developed nomogram model demonstrated a C-index of 0.855 (95% CI 0.792-0.917), with a calibrated prediction curve closely resembling the ideal curve. An elevated PLR is an independent risk factor for LNM in patients with small bowel cancer.
本研究旨在探讨术前系统性炎症指标在预测小肠癌患者淋巴结转移中的潜在预测价值。对 2010 年 1 月至 2021 年 6 月在我院胃肠外科接受手术治疗的小肠癌患者的临床资料进行回顾性分析。根据术后病理结果证实的淋巴结转移情况,将患者分为有淋巴结转移组和无淋巴结转移组。采用单因素分析和多因素 Logistic 回归分析比较两组患者术前炎症指标和临床资料的差异。采用 R 软件构建预测小肠癌淋巴结转移的列线图模型,并进行内部验证。本研究样本包括 140 例小肠癌患者,术后病理证实淋巴结转移 72 例。单因素分析结果表明,术前炎症指标和临床资料与小肠癌淋巴结转移有关。多因素 logistic 回归分析显示,性别、PLR、淋巴结清扫数目和脉管侵犯独立影响小肠癌患者的淋巴结转移。所建立的列线图模型的 C 指数为 0.855(95%CI 0.792-0.917),校准预测曲线与理想曲线非常接近。升高的 PLR 是小肠癌患者发生淋巴结转移的独立危险因素。