摘要
目的:开发与验证一种用于临床医师快速判断慢性胃炎患者发生胃癌风险的列线图模型。方法:根据纳入、排除标准,收集837例于2022年9月至2023年9月在我院消化内科就诊患者的人口学资料、胃癌家族史、胃镜和病理结果、幽门螺杆菌感染情况及吸烟饮酒习惯,按7∶3比例随机分为训练集(586例),验证集(251例)。基于训练集数据运用单因素、多因素Logistic回归分析及最小绝对收缩和选择算子(LASSO)筛选慢性胃炎患者发生胃癌的危险因素,使用R语言构建列线图模型并进行内部验证。通过ROC曲线、校准曲线及决策曲线分析评价列线图模型的区分度、校准度。结果:共有837例患者纳入研究,训练集586例(慢性胃炎292例,胃癌294例)、验证集251例(慢性胃炎130例,胃癌121例)。多因素Logistic回归分析发现,男性、年龄≥50岁、居住地为乡镇农村、胃癌家族史、胃黄色瘤、中重度胃黏膜萎缩、胃溃疡、幽门螺杆菌感染是慢性胃炎患者发生胃癌的独立危险因素。该模型训练集与验证集的AUC分别为0.853(95%CI 0.822~0.884)和0.886(95%CI 0.843~0.928),证明该模型具有较好的准确性。校准曲线与标准曲线重叠,无明显偏曲,说明该模型具有良好的一致性;决策曲线分析提示该模型具有潜在的临床应用价值。结论:基于男性、年龄≥50岁、居住地为乡镇农村、胃癌家族史、胃黄色瘤、中重度胃黏膜萎缩、胃溃疡、幽门螺杆菌感染危险因素构建的列线图预测模型具有较好的准确性和区分识别能力,对于预测慢性胃炎患者发生胃癌风险具有一定的临床参考价值。
Objective:To develop and valide a nomogram model for clinicians to quickly determine the risk of gastric cancer in patients with chronic gastritis.Methods:According to the inclusion and exclusion criteria,the demographic data,family history of gastric cancer,gastroscopy and pathological results,Helicobacter pylori infection,and smoking and drinking habits of 837 patients who visited the department of gastroenterology of our hospital from September 2022 to September 2023 were collected.The patients were randomly divided into training group(586 cases)and validation group(251 cases)in a 7∶3 ratio.Univariate and multivariate logistic regression analysis and minimum absolute contraction and selection operator(LASSO)were used to screen the risk factors for gastric cancer in patients with chronic gastritis based on the training set data.Nomogram models were built using R programming language and validated internally.The ROC curve,calibration curve and decision curve were used to evaluate the discrimination and calibration of the nomogram model.Results:A total of 837 patients were included in the study,including 586 cases in the training set(292 cases of chronic gastritis and 294 cases of gastric cancer)and 251 cases of validation set(130 cases of chronic gastritis and 121 cases of gastric cancer).Multivariate Logistic regression analysis showed that male sex,age≥50 years old,rural residence,family history of gastric cancer,gastric xanthoma,moderate to severe gastric mucosal atrophy,gastric ulcer,and Helicobacter pylori infection were independent risk factors for gastric cancer in patients with chronic gastritis.The AUC of the training and validation sets of the model was 0.853(95%CI 0.822~0.884)and 0.886(95%CI 0.843~0.928),respectively,indicating that the model had good accuracy.The calibration curve overlapped with the standard curve without obvious deviation,indicating that the model had good consistency,and the decision curve analysis suggested that the model had potential clinical application value.Conclusion:Th
作者
高梦杰
郭琦琦
申鑫
曹娇娇
王腾腾
时永全
GAO Mengjie;GUO Qiqi;SHEN Xin;CAO Jiaojiao;WANG Tengteng;SHI Yongquan(Department of Gastroenterology,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China;Postgraduate Department of Xi'an Medical University,Shaanxi Xi'an 710021,China;Yan'an Medical University,Shaanxi Yan'an 716000,China)
出处
《现代肿瘤医学》
CAS
2024年第24期4624-4631,共8页
Journal of Modern Oncology
基金
陕西省重点研发计划(编号:2023-ZDLSF-35)。
关键词
慢性胃炎
列线图
胃癌
胃黄色瘤
黏膜萎缩
chronic gastritis
nomogram
gastric cancer
gastric xanthoma
mucosal atrophy
