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城市居民中一种相对准确的胃癌高危人群筛查评分系统的开发与验证

Development and validation of a relatively accurate gastric cancer high-risk group screening scoring system in urban residents.

作者信息

Zhao Weipeng, Li Tian, Wang Ping, Zhang Rui, Gao Fan, Ma Zongfeng, Zhen Siqi, Liu Feng, Chu Yanliu

机构信息

Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China.

Department of Gastroenterology, Heze Municipal Hospital, Heze, China.

出版信息

Clin Transl Oncol. 2025 May;27(5):2269-2280. doi: 10.1007/s12094-024-03748-2. Epub 2024 Oct 8.

Abstract

PURPOSE

Our study aimed to develop a relatively accurate gastric cancer (GC) screening score system for urban residents and to validate the screening efficacy.

METHODS

The present study included a derivation cohort (n = 3406) and a validation cohort (n = 868) of urban residents. Applying the full-stack engineering intelligent system platform of Hualian Health Big Data of Shandong University, the clinical physical examination data of subjects were collected. Univariate and multivariate analyses were used to identify risk factors for GC, and subsequently, an optimal prediction rule was established to create three distinct scoring systems.

RESULTS

In the GC-risk scoring system I, age, plateletocrit (PCT), carcinoembryonic antigen (CEA), glucose, albumin, creatinine were independent risk factors of GC, with scores ranging from 0 to 28 and optimal cut-off was 15.5. The second scoring system consisted of age, PCT, RDW-CV, CEA, glucose, albumin, and creatinine, with scores ranging from 0 to 31. The optimal cut-off point was determined to be 15.5. The scoring system III comprise of age, sex, PCT, RDW CV, CEA, glucose, with scores ranging from 0 to 21 and optimal cut-off was 10.5. All three scoring systems demonstrated excellent discrimination for GC, achieving an AUC of 0.884, 0.89, and 0.876, respectively. In external validation, the AUC values were 0.654, 0.658, and 0.714. Notably, the GC-risk scoring system III exhibited the highest screening efficiency.

CONCLUSIONS

Urban residents benefited from the effective and verified GC-risk scoring systems, which demonstrated excellent performance in identifying individuals with an elevated risk of GC.

摘要

目的

本研究旨在为城市居民开发一种相对准确的胃癌(GC)筛查评分系统,并验证其筛查效果。

方法

本研究纳入了城市居民的一个推导队列(n = 3406)和一个验证队列(n = 868)。应用山东大学华联健康大数据的全栈工程智能系统平台,收集受试者的临床体检数据。采用单因素和多因素分析来确定GC的危险因素,随后建立最佳预测规则以创建三种不同的评分系统。

结果

在GC风险评分系统I中,年龄、血小板压积(PCT)、癌胚抗原(CEA)、血糖、白蛋白、肌酐是GC的独立危险因素,评分范围为0至28,最佳截断值为15.5。第二个评分系统由年龄、PCT、红细胞分布宽度变异系数(RDW-CV)、CEA、血糖、白蛋白和肌酐组成,评分范围为0至31。确定最佳截断点为15.5。评分系统III包括年龄、性别、PCT、RDW CV、CEA、血糖,评分范围为0至21,最佳截断值为10.5。所有三种评分系统对GC均表现出出色的区分能力,AUC分别为0.884、0.89和0.876。在外部验证中,AUC值分别为0.654、0.658和0.714。值得注意的是,GC风险评分系统III表现出最高的筛查效率。

结论

城市居民受益于有效且经过验证的GC风险评分系统,这些系统在识别GC风险升高的个体方面表现出色。

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