摘要
目的探讨甲状腺全切除术后甲状旁腺功能减退的危险因素,构建列线图预测模型并验证其效能。方法将2019年2月~2021年5月在福建省肿瘤医院治疗的568例甲状腺癌患者作为建模组,使用LASSO回归分析以及十折交叉验证获取甲状旁腺功能减退的相关因素,二元Logistic回归分析进一步筛选高危因素,建立列线图预测模型并进行内部验证。将2021年7~12月符合同样标准的139例甲状腺癌患者作为验证组进行外部验证。结果建模组和验证组的基线资料比较差异无统计学意义(P>0.05)。建模组中,合并桥本甲状腺炎、中央区淋巴结清扫术、被膜侵犯、手术次数是甲状旁腺功能减退的独立危险因素。以此建立列线图预测模型,建模组和验证组的受试者工作特征曲线下面积分别为0.768(95%CI:0.721~0.814)和0.833(95%CI:0.769~0.896)。两组的校准曲线结果均表明预测概率和实际概率一致性良好。决策曲线表明模型的净获益水平高。结论本研究构建的甲状腺全切除术后甲状旁腺功能减退列线图预测模型具有良好的区分度和精确度,可为临床识别高危患者并制定积极的预防措施提供重要参考。
Objective To investigate the risk factors of hypoparathyroidism after total thyroidectomy,construct a nomogram prediction model and verify its efficacy.Methods 568 patients with thyroid cancer treated in Fujian Cancer Hospital from Feb 2019 to May 2021 were taken as the modeling group.The relevant factors of hypoparathyroidism were obtained by LASSO regression analysis and ten fold cross validation.The binary Logistic regression analysis was used to further screen the high-risk factors,and establish the nomogram prediction model and carried out internal validation.139 patients with thyroid cancer who met the same criteria from Jul to Dec 2021 were taken as the validation group for external validation.Results There was no significant difference in baseline data between the modeling group and the validation group.In the modeling group,Hashimoto's thyroiditis,central lymph node dissection,capsule invasion and the number of operations were independent risk factors for hypoparathyroidism.On this basis,the nomogram prediction model was established.The area under the receiver operating characteristic curve in the modeling group and the validation group were 0.768(95%CI:0.721~0.814)and 0.833(95%CI:0.769~0.896)respectively.The calibration curves of the two groups showed that the predicted probability were in good agreement with the actual probability.The decision curves showed that the net benefit level of the model were high.Conclusion The nomogram prediction model of hypoparathyroidism after total thyroidectomy constructed in this study has good discrimination and accuracy.It may be help to identify high-risk patients and take prevent measures actively.
作者
吴雪婷
陈英
林丽英
Wu Xueting;Chen Ying;Lin Liying(Clinical Oncology School of Fujian Medical University,Fuzhou 350014)
出处
《中国现代医药杂志》
2023年第3期28-32,共5页
Modern Medicine Journal of China
