浙江大学学报（医学版）2025，Vol.54Issue(3)：297-306,10.DOI:10.3724/zdxbyxb-2024-0542
基于中医证型构建胃高级别上皮内瘤变预测模型
Prediction model for transformation of chronic atrophic gastritis to high-grade intraepithelial neoplasia based on traditional Chinese medicine syndrome patterns
摘要
Abstract
Objective:To develop a risk prediction model for the transformation of chronic atrophic gastritis to high-grade intraepithelial neoplasia(HGIN)based on traditional Chinese medicine(TCM)syndrome patterns.Methods:Clinical data of 201 chronic atrophic gastritis patients who visited the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine and Dong'erhuan Branch between January 2022 and March 2023 were retrospectively analyzed,including 32 patients with HGIN(HGIN group)and 169 patients with moderate and severe chronic atrophic gastritis(non-HGIN group).The information of demographic characteristics,dietary habits,lifestyle factors,social and psychosocial factors,family history of tumors,medical history and comorbidities,long-term medication,endoscopic findings,histopathological examination results,as well as TCM syndrome types were collected.Potential HGIN risk factors were screened using LASSO regression,and the significant risk factors for establishing an HGIN risk prediction model were identified using logistic regression analysis.The final model was visually presented using a nomogram,and its diagnostic performance was evaluated through receiver operating characteristic curve analysis.Results:Spleen-stomach Qi deficiency was the most common TCM syndrome in both HGIN and non-HGIN groups.LASSO-logistic regression model analysis showed that heavy alcohol consumption(X1),syndrome of static blood in stomach collaterals(X2),low-grade intraepithelial neoplasia(X3),high-salt diet(X4),and age(X5)were independent risk factors related to the occurrence of HGIN,and the predictive model was ln[P/(1-P)]=2.159X1+2.230X2+1.664X3+2.070X4+0.122X5-11.096.The model demonstrated good discriminative ability,calibration,and goodness-of-fit,with area under the curve values of 0.940 and 0.891 in the training and validation sets,respectively.Conclusions:The TCM syndrome of static blood in stomach collaterals shows correlation with the transformation from chronic atrophic gastritis to HGIN.The HGIN prediction model based on TCM syndrome patterns developed in the study demonstrates potential value in clinical application.关键词
高级别上皮内瘤变/中医证型/胃络瘀阻证/危险因素/预测模型/临床研究Key words
High-grade intraepithelial neoplasia/Traditional Chinese medicine syndrome/Syndrome of static blood in stomach collaterals/Risk factors/Prediction model/Clinical study分类
医药卫生引用本文复制引用
林翔英,施婧瑶,黄小燕,郑泽宇,黄晓峰,黄铭涵..基于中医证型构建胃高级别上皮内瘤变预测模型[J].浙江大学学报（医学版）,2025,54(3):297-306,10.基金项目
国家自然科学基金(82174365) The study was supported by the National Natural Science Foundation of China(82174365). （82174365）
