实用临床医药杂志2024，Vol.28Issue(23)：52-57,64,7.DOI:10.7619/jcmp.20242972
胃癌术后炎性并发症的危险因素分析及列线图预测模型构建
Risk factor and nomogram prediction model construction for postoperative inflammatory complications in gastric cancer patients
摘要
Abstract
Objective To investigate the risk factors for inflammatory complications after radical gastrectomy for gastric cancer and construct a nomogram model for risk prediction.Methods The clinical data of 402 patients with primary gastric cancer who underwent radical gastrectomy were retro-spectively analyzed.All patients underwent preoperative Nutritional Risk Screening 2002(NRS2002)score,Patient-Generated Subjective Global Assessment(PG-SGA)grading,Lumbar 3 Skeletal Mus-cle Index(L3-SMI)assessment,and serological index testing.Univariate analysis was used to screen for influencing factors of postoperative inflammatory complications of gastric cancer,and multivariate Logistic regression analysis was conducted to determine independent risk factors.A nomogram model for predicting postoperative inflammatory complications after radical gastrectomy was constructed based on the results of multivariate Logistic regression analysis,and the predictive performance of the model was evaluated using the receiver operating characteristic(ROC)curve and cal ibration curve.Results Univariate analysis revealed that age,TNM stage,body mass index,preoperative hemoglobin,preoperative albumin,preoperative globulin,NRS2002 score,PG-SGA grade,and L3-SMI were influencing factors of postoperative inflammatory complications in patients undergoing radical gastrectomy(P＜0.05).Multivariate Logistic regression analysis showed that age≤60 years,preoperative hemoglobin ≤130 g/L(male)or≤115 g/L(female),TNM staging of Ⅳstage,NRS2002 score ≥ 3,and L3-SMI ≤52.4 cm2/m2(male)or ≤38.5 cm2/m2(female)were independent risk factors for postoperative inflammatory complications in gastric cancer patients(P＜0.05).A nomogram model was constructed based on age,preoperative hemoglobin,TNM stage,and NRS2002 score.The ROC curve showed that the area under the curve of the nomogram model was 0.930,with sensitivity and specificity of 93.2％and 89.2％,respectively.The calibration curve demonstrated good consistency between the predicted probability of inflammatory complications and the actual outcomes.Conclusion Age≤60 years,low preoperative hemoglobin,TNM staging of Ⅳ stage,NRS2002 score ≥3,and low L3-SMI are independent risk factors for postoperative in-flammatory complications in gastric cancer patients.The nomogram model constructed based on age,preoperative hemoglobin,TNM stage,and NRS2002 score can accurately predict postoperative in-flammatory complications after gastrectomy for gastric cancer.关键词
胃癌/营养风险筛查2002评分/患者主观整体评估评分/第3腰椎骨骼肌质量指数/炎性并发症Key words
gastric cancer/Nutritional Risk Screening 2002 score/patient-generated subjec-tive global assessment score/lumbar 3 skeletal muscle index/inflammatory complications分类
医药卫生引用本文复制引用
徐宁,索晨,许桥一,高进,陈雅琳,汤黎明..胃癌术后炎性并发症的危险因素分析及列线图预测模型构建[J].实用临床医药杂志,2024,28(23):52-57,64,7.基金项目
国家重点研究发展计划课题(2023YFC2508001) （2023YFC2508001）
胃肠病学重点实验室项目(CM20223008) （CM20223008）
江苏省常州市"十四五"高层次才培养项目(2022CZLJ017) （2022CZLJ017）
南京医科大学常州医学中心项目(PCMCB202212,PCMCM202204) （PCMCB202212,PCMCM202204）
