Cheng De-Xin, Xu Kang-Di, Liu Han-Bo, Liu Yi
Cancer Center, Department of Interventional Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China.
General Surgery, Cancer Center, Department of Vascular Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China.
World J Gastrointest Surg. 2024 Apr 27;16(4):1055-1065. doi: 10.4240/wjgs.v16.i4.1055.
Colon cancer is one of the most common malignant tumors of the digestive system. Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.
To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery.
We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People's Hospital from December 2019 to December 2022. Patients were divided into liver metastasis and non-liver metastasis groups. Sex, age, and other general and clinicopathological data (preoperative blood routine and biochemical test indexes) were compared. The risk factors for liver metastasis were analyzed using single-factor and multifactorial logistic regression. A predictive model was then constructed and evaluated for efficacy.
Systemic inflammatory index (SII), C-reactive protein/albumin ratio (CAR), red blood cell distribution width (RDW), alanine aminotransferase, preoperative carcinoembryonic antigen level, and lymphatic metastasis were different between groups ( < 0.05). SII, CAR, and RDW were risk factors for liver metastasis after colon cancer surgery ( < 0.05). The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively. The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve, with good agreement. The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases, indicating that the model is safer.
Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII, CAR, and RDW.
结肠癌是消化系统最常见的恶性肿瘤之一。结肠癌手术后发生肝转移是结肠癌患者死亡的主要原因。
构建一个包含多种因素的新型列线图模型，以预测结肠癌手术后的肝转移情况。
我们回顾性分析了2019年12月至2022年12月在浙江省人民医院收治并接受结肠癌根治性切除术的242例结肠癌患者。将患者分为肝转移组和非肝转移组。比较性别、年龄以及其他一般和临床病理数据（术前血常规和生化检查指标）。采用单因素和多因素逻辑回归分析肝转移的危险因素。然后构建预测模型并评估其疗效。
两组之间全身炎症指数（SII）、C反应蛋白/白蛋白比值（CAR）、红细胞分布宽度（RDW）、谷丙转氨酶、术前癌胚抗原水平和淋巴结转移情况存在差异（<0.05）。SII、CAR和RDW是结肠癌手术后肝转移的危险因素（<0.05）。基于这些危险因素构建的列线图预测模型区分术后是否发生肝转移的曲线下面积为0.93。列线图预测术后肝转移风险的实际曲线接近理想曲线，一致性良好。决策曲线分析中的预测模型曲线在较大阈值范围内比极端情况下显示出更高的净效益，表明该模型更安全。
基于SII、CAR和RDW的列线图可以很好地预测结直肠癌手术后的肝转移情况。
