摘要
Abstract
Objective To evaluate the predictive value of the Systemic Inflammation Response Index(SIRI)for non-curative resection during endoscopic submucosal dissection(ESD)treatment of early-stage colorectal cancer(CRC),and to develop a nomogram-based prediction model.Methods Retrospective data were collected from 235 patients diagnosed with early-stage CRC who underwent ESD at our hospital between January 2016 and August 2024.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive performance of inflamma-tory markers,such as the SIRI,for non-curative resection following ESD.Logistic regression analysis was conducted to identify independent risk factors associated with non-curative resection,and a prediction model was developed based on these factors.The model was internally validated.Results The incidence of non-curative resection in the study population was 26.38%(62 out of 235 cases).Inflammatory markers,specifically SIRI and SII,demonstrated predictive value for non-curative resection following ESD in patients with early-stage CRC,with SIRI exhibiting a higher predictive accuracy(AUC=0.704).Logistic regression analysis identified age,family history,CEA,SIRI,and SII as independent risk factors for non-curative resection(all P<0.05).Based on these findings,a nomogram prediction model incorporating age,family history,CEA,and SIRI was developed,achieving a C-index of 0.741(95%CI:0.675～0.806).The model′s performance was validated using the Bootstrap method,and the decision curve analysis indicated satisfactory predictive accuracy.Conclusions SIRI demonstrates superior predictive value compared to SII for non-curative resection following ESD in patients with early-stage CRC.Independent risk factors for non-curative resection after ESD include age,family history,CEA levels,SIRI,and SII.A nomogram prediction model constructed using these risk factors-specifically age,family history,CEA levels,and SIRI-can effectively pre-dict the likelihood of non-curative resection after ESD.关键词
全身炎症反应指数/早期结直肠癌/内镜黏膜下剥离术/非治愈性切除Key words
systemic inflammation response index/early colorectal cancer/endoscopic submucosal dissection/non-curative resection分类
医药卫生
