A nomogram of inflammatory indexes for preoperatively predicting the risk of lymph node metastasis in colorectal cancer.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2024-11-04 DOI:10.1007/s10151-024-03010-5

Xuemei Wen, Haoran Sun, Shijiang Du, Junkai Xia, Wenjun Zhang, Fujie Zhang

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引用次数: 0

Abstract

Purpose: To investigate the independent risk factors associated with the development of lymph node metastasis (LNM) in patients with colorectal cancer (CRC), focusing on preoperative systemic inflammatory indicators, and to construct a corresponding risk predictive model.

Materials and methods: The clinical data of 241 patients with CRC who underwent surgery after the first diagnosis between January 2012 and December 2017 at our hospital were reviewed. A best logistic regression model was constructed by Lasso regression for multivariate analysis, from which a Nomogram was derived. Using bootstrap to conduct internal validation. The model's predictive performance and clinical practicability were evaluated using the receiver operating characteristic curve (ROC) curve, calibration curve, and decision curve analysis (DCA). External validation was conducted using retrospective data from 170 patients who underwent surgery between January 2020 and May 2022 at another hospital.

Results: Cross-validation indicated smoking history, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), fibrinogen-albumin ratio (FAR), and fecal occult blood (FOB) as variables with non-zero coefficients. These factors were included in the logistic regression, and multivariate analysis confirmed that smoking history, NLR, LMR, FAR, and FOB were independent risk factors (P < 0.05). The ROC and calibration curve of the original model and external validation indicated strong predictive power of the model. DCA suggested the model's favorable clinical utility.

Conclusions: The model constructed in this study has robust predictive performance and clinical utility for the preoperative determination of CRC LMN, offering significant for clinical decision-making in patients with CRC.

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用于术前预测结直肠癌淋巴结转移风险的炎症指数提名图。

目的：研究与结直肠癌（CRC）患者发生淋巴结转移（LNM）相关的独立风险因素，重点关注术前全身炎症指标，并构建相应的风险预测模型：回顾性分析我院2012年1月至2017年12月期间首次确诊后接受手术治疗的241例CRC患者的临床资料。通过Lasso回归构建最佳Logistic回归模型进行多变量分析，并从中得出Nomogram。采用引导法进行内部验证。利用接收者操作特征曲线（ROC）、校准曲线和决策曲线分析（DCA）评估了模型的预测性能和临床实用性。外部验证使用了2020年1月至2022年5月期间在另一家医院接受手术的170名患者的回顾性数据：交叉验证表明，吸烟史、中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）、淋巴细胞-单核细胞比值（LMR）、纤维蛋白原-白蛋白比值（FAR）和粪便潜血（FOB）是系数不为零的变量。这些因素都被纳入了逻辑回归，多变量分析证实，吸烟史、NLR、LMR、FAR 和 FOB 是独立的风险因素（P 结论：本研究构建的模型具有较高的可信度：本研究构建的模型在术前确定 CRC LMN 方面具有很强的预测能力和临床实用性，对 CRC 患者的临床决策具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.