WJG:术前预测结直肠癌肿瘤沉积列线图的建立和验证

2023-11-17 xuyihan MedSci原创 发表于上海

本研究开发并验证了一种具有良好预测性能的列线图,用于识别结直肠癌患者的肿瘤沉积。我们的预测模型可以帮助外科医生做出最佳的治疗决策。

直肠癌(CRC)胃肠道中常见的恶性肿瘤,早期症状不明显,随着癌肿的增大而表现排便习惯改变、便血、腹泻、腹泻与便秘交替、局部腹痛等症状,晚期则表现贫血、体重减轻等全身症状。CRC是全球第三大常见癌症,每年有超过100万新病例,使其成为癌症死亡的第二大原因。目前,CRC的治疗以肿瘤、淋巴结和转移(TNM)分期系统为基础。术前准确评估肿瘤沉积(TDs)具有挑战性。本研究旨在通过构建列线图来解决这一问题,该列线图可以准确有效地预测CRC患者发生TDs的可能性。从而识别复发高危人群,为个体化治疗策略提供有价值的信息,最终改善预后。

回顾性分析645例符合纳入标准的结直肠癌患者,按照7:3的比例随机分为训练组(452例)和验证组(193例)。采用最小绝对收缩和选择算子回归分析筛选潜在危险因素,采用多因素logistic回归分析确定独立危险因素。基于独立危险因素构建结直肠癌患者癌结节形成的预测模型。采用受试者工作特征曲线、曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)评估模型的区分能力、与实际结果的一致性和临床适用性。

 

基于术后病理标本,34例(7.5%)患者被确定为训练组。多因素logistic回归分析显示女性、术前肠梗阻、左侧结直肠癌和淋巴结转移是癌结节形成的独立危险因素。使用这些变量构建的列线图模型在训练集和验证集的AUC分别为0.839和0.853。校准曲线显示一致性较好,训练队列DCA的阈值概率为7% ~ 78%。

 

本研究开发并验证了一种具有良好预测性能的列线图,用于识别结直肠癌患者的肿瘤沉积。我们的研究发现女性、术前肠梗阻、左侧结直肠癌和淋巴结转移是结直肠癌肿瘤沉积的预测因素。我们的预测模型可以帮助外科医生做出最佳的治疗决策。

原始出处:

Zheng HD, Hu YH, Ye K, Xu JH. Development and validation of a nomogram for preoperative prediction of tumor deposits in colorectal cancer. World J Gastroenterol. 2023 Oct 21;29(39):5483-5493. doi: 10.3748/wjg.v29.i39.5483.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2169283, encodeId=a3f7216928349, content=好文章,谢谢共享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Sat Nov 18 10:03:13 CST 2023, time=2023-11-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2169254, encodeId=fe502169254a5, content=设计合理,好看, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9428741691, createdName=ms5000001846373376, createdTime=Sat Nov 18 07:56:07 CST 2023, time=2023-11-18, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2169244, encodeId=acec2169244bc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e128592359, createdName=ms4000001539575937, createdTime=Sat Nov 18 07:29:16 CST 2023, time=2023-11-18, status=1, ipAttribution=湖北省), GetPortalCommentsPageByObjectIdResponse(id=2169197, encodeId=c094216919eb1, content=<a href='/topic/show?id=493ae869206' target=_blank style='color:#2F92EE;'>#结直肠癌#</a> <a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78692, encryptionId=493ae869206, topicName=结直肠癌), TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cade5395722, createdName=梅斯管理员, createdTime=Fri Nov 17 22:47:00 CST 2023, time=2023-11-17, status=1, ipAttribution=上海)]
    2023-11-18 yangchou 来自浙江省

    好文章,谢谢共享。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2169283, encodeId=a3f7216928349, content=好文章,谢谢共享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Sat Nov 18 10:03:13 CST 2023, time=2023-11-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2169254, encodeId=fe502169254a5, content=设计合理,好看, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9428741691, createdName=ms5000001846373376, createdTime=Sat Nov 18 07:56:07 CST 2023, time=2023-11-18, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2169244, encodeId=acec2169244bc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e128592359, createdName=ms4000001539575937, createdTime=Sat Nov 18 07:29:16 CST 2023, time=2023-11-18, status=1, ipAttribution=湖北省), GetPortalCommentsPageByObjectIdResponse(id=2169197, encodeId=c094216919eb1, content=<a href='/topic/show?id=493ae869206' target=_blank style='color:#2F92EE;'>#结直肠癌#</a> <a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78692, encryptionId=493ae869206, topicName=结直肠癌), TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cade5395722, createdName=梅斯管理员, createdTime=Fri Nov 17 22:47:00 CST 2023, time=2023-11-17, status=1, ipAttribution=上海)]
    2023-11-18 ms5000001846373376 来自内蒙古

    设计合理,好看

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2169283, encodeId=a3f7216928349, content=好文章,谢谢共享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Sat Nov 18 10:03:13 CST 2023, time=2023-11-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2169254, encodeId=fe502169254a5, content=设计合理,好看, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9428741691, createdName=ms5000001846373376, createdTime=Sat Nov 18 07:56:07 CST 2023, time=2023-11-18, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2169244, encodeId=acec2169244bc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e128592359, createdName=ms4000001539575937, createdTime=Sat Nov 18 07:29:16 CST 2023, time=2023-11-18, status=1, ipAttribution=湖北省), GetPortalCommentsPageByObjectIdResponse(id=2169197, encodeId=c094216919eb1, content=<a href='/topic/show?id=493ae869206' target=_blank style='color:#2F92EE;'>#结直肠癌#</a> <a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78692, encryptionId=493ae869206, topicName=结直肠癌), TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cade5395722, createdName=梅斯管理员, createdTime=Fri Nov 17 22:47:00 CST 2023, time=2023-11-17, status=1, ipAttribution=上海)]
    2023-11-18 ms4000001539575937 来自湖北省

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2169283, encodeId=a3f7216928349, content=好文章,谢谢共享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Sat Nov 18 10:03:13 CST 2023, time=2023-11-18, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2169254, encodeId=fe502169254a5, content=设计合理,好看, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9428741691, createdName=ms5000001846373376, createdTime=Sat Nov 18 07:56:07 CST 2023, time=2023-11-18, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=2169244, encodeId=acec2169244bc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e128592359, createdName=ms4000001539575937, createdTime=Sat Nov 18 07:29:16 CST 2023, time=2023-11-18, status=1, ipAttribution=湖北省), GetPortalCommentsPageByObjectIdResponse(id=2169197, encodeId=c094216919eb1, content=<a href='/topic/show?id=493ae869206' target=_blank style='color:#2F92EE;'>#结直肠癌#</a> <a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78692, encryptionId=493ae869206, topicName=结直肠癌), TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cade5395722, createdName=梅斯管理员, createdTime=Fri Nov 17 22:47:00 CST 2023, time=2023-11-17, status=1, ipAttribution=上海)]

相关资讯

结直肠癌治疗的新途径-生酮饮食

最近发表在著名的《Nature》杂志上的一篇研究文章显示,在小鼠模型中,生酮饮食有抑制结直肠癌的作用。

Genome Medicine:基于人血浆蛋白质组与基因组数据,鉴定新型CRC蛋白质标志物及药物靶点

研究团队对4,853种血浆蛋白与CRC风险之间的因果关联进行了全面研究;采用单细胞类型表达分析来检测结肠肿瘤组织中富集的细胞类型,并进行成药性评估,以探索其作为CRC治疗靶点的潜力。

GUT:NOTUM基因在结直肠癌中的致病作用

本研究一起强调了NOTUM基因在癌症发病、进展和转移中的作用,并强调需要进一步定义其在通过各种格lypicans直接调节Wnt信号和调节其他关键信号通路中的作用。

Cancer Res:模拟禁食或许真能抗癌!复旦大学缪长虹/刘荣花发现模拟禁食促进对结直肠癌抗肿瘤免疫的潜在机理

该研究旨在阐明FMD诱导的代谢重编程在结直肠癌抗肿瘤免疫激活中的作用。

AJG:炎症性肠病相关的结直肠癌流行病学和结局

与散发性CRC相比,IBD相关CRC发生于较年轻的患者,且结局较差。我们迫切需要找到这些差异的原因,从而指导这一高危人群的CRC及其前体的筛查、监测和治疗策略。