协和医学杂志2024，Vol.15Issue(1)：99-108,10.DOI:10.12290/xhyxzz.2023-0261
白蛋白-胆红素评分联合肝功能指标及CEA对结直肠癌肝转移的预测价值
Predictive Value of Albumin-Bilirubin Score Combined with Liver Function Index and CEA for Liver Metastasis of Colorectal Cancer
摘要
Abstract
Objective To investigate the predictive value of albumin-bilirubin(ALBI)score combined with liver function index and carcinoembryonic antigen(CEA)for liver metastasis of colorectal cancer.Methods We retrospectively analyzed the clinical data of patients with colorectal cancer who underwent surgical treatment in the Second Hospital&Clinical Medical Hospital,Lanzhou University from January 2016 to July 2021 and were followed up for 24 months.According to the follow-up results,the enrolled patients were divided into liver metastasis group and non-liver metastasis group,and were randomly divided into modeling group and valida-tion group by a ratio of 2∶ 1.The risk factors of liver metastasis in the patients with colorectal cancer were ana-lyzed.Lasso-Logistic regression was used to construct the prediction model.Bootstrap method was used for internal verification.Receiver operating characteristic curve,calibration curve and clinical decision curve were used to evaluate the reliability of the prediction model.Finally,a nomogram was drawn to show the prediction results.Results A total of 195 patients who met the inclusion and exclusion criteria were enrolled,including 130 in the modeling group and 65 in the validation group.Through Lasso regression variable screening and Logistic regression analysis,the results showed that ALBI score(OR=8.062,95%CI:2.545-25.540),alanine transaminase(ALT)(OR=1.037,95%CI:1.004-1.071)and CEA(OR=1.025,95%CI:1.008-1.043)were inde-pendent predictors of liver metastasis in colorectal cancer.The area under curve(AUC)of the combined predic-tion of liver metastasis of colorectal cancer in the modeling group was 0.921,the sensitivity was 78%,the speci-ficity was 95%,the C-index was 0.921,the H-L fitting curve χ2=0.851,P=0.654,and the slope of the cali-bration curve was close to 1,suggesting that the accuracy of the model was high,and the DCA curve showed that the model had good clinical application value.For the data of the modeling group,the Bootstrap method was used for internal verification of 1000 resamplings.The accuracy was 0.869,the kappa consistency was 0.709,and the AUC was 0.913.When ALBI score,ALT and CEA were used to diagnose liver metastasis of colorectal cancer alone,the AUC of CEA was the largest(0.897),and the combination of the three had the highest efficacy in the diagnosis of liver metastasis of colorectal cancer.In the validation group,the AUC,sensitivity,specificity,C-in-dex of the combined prediction of liver metastasis of colorectal cancer were 0.918,85.0%,95.6%,0.918,re-spectively,and H-L fitting curve χ2=0.586,P=0.746.Conclusions ALBI score,ALT and CEA have certain predictive value for liver metastasis of colorectal cancer.The combined diagnosis of liver metastasis of colorectal cancer has high efficacy,and the risk prediction model constructed has a good predictive effect.关键词
白蛋白-胆红素评分/癌胚抗原/结直肠癌/肝转移/预测价值Key words
albumin-bilirubin score/CEA/colorectal cancer/liver metastasis/predictive value分类
医药卫生引用本文复制引用
樊万里,何栋,张树泽,陈刚,赵斌,程志斌..白蛋白-胆红素评分联合肝功能指标及CEA对结直肠癌肝转移的预测价值[J].协和医学杂志,2024,15(1):99-108,10.基金项目
国家自然科学基金(82060508) （82060508）
甘肃省卫生行业计划(GSWSKY-2019-66) （GSWSKY-2019-66）
甘肃省卫生行业科研计划(GSWSKY2022-12) （GSWSKY2022-12）
兰州大学第二医院"萃英科技创新"计划(2020QN-21) National Natural Science Foundation(82060508) （2020QN-21）
Gansu Province Health Industry Plan(GSWSKY-2019-66) （GSWSKY-2019-66）
Gansu Province Health Industry Research Project(GSWSKY2022-12) （GSWSKY2022-12）
"Cuiying Science and Technology Innovation"Project of the Second Hospital&Clinical Medical School,Lanzhou University(2020QN-21) （2020QN-21）
