国际神经病学神经外科学杂志2025，Vol.52Issue(6)：56-63,8.DOI:10.16636/j.cnki.jinn.1673-2642.2025.06.008
基于临床-病理-影像指标构建预测模型评估脑膜瘤术后脑水肿加重的风险
Value of a predictive model based on clinical-pathological-imaging indicators in assessing the aggravation of cerebral edema after meningioma surgery
摘要
Abstract
Objective To investigate the value of a predictive model based on clinical-pathological-imaging indicators in assessing the aggravation of cerebral edema after meningioma surgery.Methods A retrospective analysis was performed for the clinical,pathological,and imaging data of 100 patients with meningioma who received meningioma surgery in Kaifeng Central Hospital from January 2020 to January 2024,and according to the presence or absence of the aggravation of cerebral edema after surgery,the patients were divided into aggravation group with 26 patients and non-aggravation group with 74 patients.A logistic regression analysis was used to investigate the influencing factors for the aggravation of cerebral edema after surgery in patients with meningioma,and a logistic regression predictive model was established based on the above risk factors.The receiver operating characteristic(ROC)curve was plotted,and the area under the ROC curve(AUC)was used to assess the value of the model based on clinical-pathological-imaging indicators in predicting the aggravation of cerebral edema after surgery in patients with meningioma.The Bootstrap method was used for internal validation.Results Among the 100 patients with meningioma,26.00%(26/100)had aggravation of cerebral edema after surgery.The multivariate logistic regression analysis showed that preoperative peritumoral edema(odds ratio[OR]=1.687,95%confidence interval[CI]:1.443-1.931),tumor size(OR=1.790,95%CI:1.653～1.926),tumor location(OR=1.840,95%CI:1.733～1.948),and CT-enhanced morphology(OR=1.811,95%CI:1.702～1.920)were risk factors for aggravation of cerebral edema after surgery in patients with meningioma.The logistic regression clinical-pathological-imaging predictive model based on the above factors was established as Logistic(P)=-4.326+0.523(preoperative peritumoral edema)+0.582(tumor size)+0.610(tumor location)+0.594(CT-enhanced morphology),with a sensitivity of 81.21%,a specificity of 90.58%,and an AUC of 0.914 in predicting the aggravation of cerebral edema after surgery in patients with meningioma.Robustness testing was performed for the risk prediction model with a sensitivity of 81.21%,a specificity of 90.58%,a positive predictive value of 85.30%,a negative predictive value of 88.10%,an accuracy rate of 87.50%,a precision rate of 85.30%,a recall rate of 81.21%,and a comprehensive evaluation index(F1-Score)of 83.20%,with a coefficient of variation of 5.2%(<10%)for F1-Score.Conclusions The clinical-pathological-imaging model constructed based on preoperative peritumoral edema,tumor size,tumor location,and CT-enhanced morphology has high sensitivity,specificity,and AUC in predicting the aggravation of brain edema after surgery in meningioma patients,with a good predictive performance and a high clinical application value.关键词
脑膜瘤/脑水肿/瘤周水肿/病理特征/CT增强形态/脑肿瘤/手术Key words
meningioma/cerebral edema/peritumoral edema/pathological features/CT-enhanced morphology/brain tumors/surgery分类
医药卫生引用本文复制引用
宋万立,张海军..基于临床-病理-影像指标构建预测模型评估脑膜瘤术后脑水肿加重的风险[J].国际神经病学神经外科学杂志,2025,52(6):56-63,8.基金项目
2023年度开封市科技发展计划(2303069). （2303069）
