Ma Ruiying, Lu Zhibin, Zhu Jianguang, Bai Yundong, Wang Xuyan
Department of ENT (ear-nose-throat), The 82nd Group Army Hospital of the Chinese People's Liberation Army, Baoding, Hebei, China.
Front Surg. 2025 Apr 25;12:1581417. doi: 10.3389/fsurg.2025.1581417. eCollection 2025.
To analyze the factors influencing recurrence after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). A nomogram model for risk prediction was constructed and validated.
Retrospective analysis of clinical data of 460 patients with chronic sinusitis and nasal polyps at the 82nd Group Military Hospital of the People's Liberation Army of China from January 2020 to May 2022. Randomly divide into training set ( = 322) and validation set ( = 138) in a 7:3 ratio. Divide the training set into a Recurrence group or a Non-recurrence group based on whether the patient relapses within one year after surgery. Analysis the risk factors of postoperative recurrence in patients and draw a risk prediction nomogram model.
Gastroesophageal reflux disease (GERD), bronchial asthma, sinusitis type, allergic rhinitis, eosinophil count, neutrophil count, lymphocyte count, and total sinus score were independent risk factors for postoperative recurrence in CRSwNP patients ( < 0.05). The Nomogram model constructed based on the above factors was validated, and the results showed that the C-indices of the training set and validation set are 0.935 and 0.923, respectively. The internal validation receiver operating characteristic (ROC) curve of area under the curve (AUC) was 0.948; The external validation set AUC is 0.932. The decision curve shows a higher net benefit value when the threshold probability is between 5% and 100%.
The predictive nomogram model constructed in this article has high recognition efficiency.
分析影响慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者内镜鼻窦手术（ESS）后复发的因素。构建并验证风险预测列线图模型。
回顾性分析2020年1月至2022年5月中国人民解放军第82集团军医院460例慢性鼻窦炎和鼻息肉患者的临床资料。按7:3比例随机分为训练集（n = 322）和验证集（n = 138）。根据患者术后1年内是否复发将训练集分为复发组和未复发组。分析患者术后复发的危险因素并绘制风险预测列线图模型。
胃食管反流病（GERD）、支气管哮喘、鼻窦炎类型、变应性鼻炎、嗜酸性粒细胞计数、中性粒细胞计数、淋巴细胞计数和鼻窦总分是CRSwNP患者术后复发的独立危险因素（P < 0.05）。对基于上述因素构建的列线图模型进行验证，结果显示训练集和验证集的C指数分别为0.935和0.923。内部验证的受试者工作特征（ROC）曲线下面积（AUC）为0.948；外部验证集AUC为0.932。决策曲线显示当阈值概率在5%至100%之间时净效益值较高。
本文构建的预测列线图模型具有较高的识别效率。
