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用于个性化评估结肠癌患者术后复发风险的风险预测模型的开发。

Development of a risk prediction model for personalized assessment of postoperative recurrence risk in colon cancer patients.

作者信息

Zhang Jing-Jing, Liu Ya-Meng, Li Ya-Wei, Han Zheng-Quan

机构信息

Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.

出版信息

Transl Cancer Res. 2024 Nov 30;13(11):5873-5882. doi: 10.21037/tcr-24-948. Epub 2024 Nov 27.

Abstract

BACKGROUND

Colon cancer, a significant contributor to cancer-related mortality worldwide, exhibits a high recurrence rate in patients following surgical intervention, particularly when the disease has progressed to intermediate or advanced stages. This study undertakes a comprehensive analysis of the risk factors influencing postoperative recurrence in patients with middle- to late-stage colon cancer and subsequently develops a columnar graphical prediction model based on these findings. This model seeks to enhance the capability of identifying the risk of postoperative recurrence in patients with intermediate and advanced colon cancer, thereby providing a scientific foundation for the development of more personalized and effective prevention and management strategies.

METHODS

An analysis was conducted on a cohort of 209 patients diagnosed with colon cancer and treated at our hospital between 2020 and 2021. Clinical data were gathered to compare recurrence rates of postoperative colon cancer among patients with different influencing factors. Logistic regression analysis was utilized to determine independent factors affecting the recurrence rate of postoperative colon cancer. A nomogram risk prediction model was developed and assessed for its effectiveness.

RESULTS

The results of the regression analysis indicated that "Tumor stage" (stage IV), "Lymph node metastasis" (presence), "the level of C-reactive protein", and "the level of carcinoembryonic antigen" were identified as independent risk factors for postoperative colon cancer recurrence in patients. Additionally, "Differentiation degree" (medium/high), "Chemotherapy (have)", and "the level of serum albumin" were found to be associated with a decreased risk of recurrence. A nomogram prediction model was created using the mentioned risk factors, showing a link between higher scores and higher postoperative colon cancer recurrence rates. The model had a C-index of 0.834 [95% confidence interval (CI): 0.776-0.892] and was internally validated for strong and consistent performance.

CONCLUSIONS

This study developed a nomogram prediction model to forecast the recurrence rate of postoperative colon cancer by identifying independent influencing factors. The model demonstrates strong discrimination and consistency, offering valuable guidance in promptly assessing the likelihood of postoperative colon cancer recurrence in patients and implementing timely and effective preventive measures.

摘要

背景

结肠癌是全球癌症相关死亡的重要原因,在手术干预后的患者中复发率很高,尤其是当疾病进展到中晚期时。本研究对影响中晚期结肠癌患者术后复发的危险因素进行了全面分析,并基于这些发现建立了柱状图预测模型。该模型旨在提高识别中晚期结肠癌患者术后复发风险的能力,从而为制定更个性化、有效的预防和管理策略提供科学依据。

方法

对2020年至2021年期间在我院诊断为结肠癌并接受治疗的209例患者进行队列分析。收集临床数据以比较不同影响因素患者的结肠癌术后复发率。采用逻辑回归分析确定影响结肠癌术后复发率的独立因素。开发了列线图风险预测模型并评估其有效性。

结果

回归分析结果表明,“肿瘤分期”(IV期)、“淋巴结转移”(存在)、“C反应蛋白水平”和“癌胚抗原水平”被确定为患者结肠癌术后复发的独立危险因素。此外,“分化程度”(中/高)、“化疗(进行)”和“血清白蛋白水平”与复发风险降低有关。使用上述危险因素创建了列线图预测模型,显示得分越高,结肠癌术后复发率越高。该模型的C指数为0.834 [95%置信区间(CI):0.776 - 0.892],并在内部验证了其强大且一致的性能。

结论

本研究通过识别独立影响因素建立了列线图预测模型来预测结肠癌术后复发率。该模型具有很强的区分度和一致性,为及时评估患者结肠癌术后复发的可能性并采取及时有效的预防措施提供了有价值的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c7a/11651794/da52f90de86d/tcr-13-11-5873-f1.jpg

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