Construction of a preoperative lymph node metastasis risk prediction model for colorectal cancer
Journal Title: Chinese Journal of Clinical Research - Year 2024, Vol 37, Issue 9
Abstract
Objective To investigate the independent risk factors among preoperative systemic inflammatory indicators associated with lymph node metastasis (LNM) in patients with colorectal cancer (CRC) and to construct and validate a related risk prediction model. Methods Clinical data of 241 patients with CRC who received surgery at Affiliated Xinhua Hospital of Dalian University from January 2012 to December 2017 were retrospective analyzed. Variable selection was performed using univariate analysis combined with Least Absolute Shrinkage and Selection Operator (LASSO) regression and 10-fold cross-validation. After constructing the best logistic regression model, multivariate analysis was conducted to determine the independent risk factors for preoperative LNM in CRC, and a nomogram was developed. The model was internally validated using the Bootstrap method and its predictive performance and clinical utility were evaluated through receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results Univariate analysis and LASSO regression with cross-validation identified smoking history, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), fibrinogen-to-albumin ratio (FAR), and fecal occult blood (FOB) as variables with non-zero coefficients. Multivariate analysis using these factors showed that smoking history (OR=2.669, 95%CI: 1.158-6.150, P=0.021), high NLR(OR=1.895, 95%CI: 1.379-2.605, P<0.001), low LMR (OR=0.907, 95%CI: 0.823-0.999, P=0.048), high FAR (OR=1.145, 95%CI: 1.062-1.235, P<0.001), and positive FOB (OR=2.289, 95%CI: 1.132-4.630, P=0.021) were independent risk factors for LNM in CRC (P<0.05). The ROC curve, calibration curve, and DCA curve indicated that the nomogram constructed in this study provided benefits to patients. Conclusion The risk predictive model constructed in this study demonstrated good predictive performance and clinical utility for preoperatively identifying LNM in CRC patients.
Authors and Affiliations
WEN Xuemei , SUN Haoran, DU Shijiang, XIA Junkai, YU Hanchao, ZHANG Wenjun
Effects of single subanesthetic dose of oxycodone on pain and Th1/Th2 balance in patients after radical mastectomy
Objective To compare the effects of oxycodone and fentanyl on postoperative pain relief,immune balance of T-helper cells(Th),and adverse reactions in radical mastectomy. Methods A total of 120 female patients whounde...
Research advances on the association of nicotinic acetylcholine receptor-related genes and their polymorphisms with lung cancer
Pulmonary embolism and deep venous thrombosis are collectively referred to as venous thromboembolism, while pulmonary embolism is generally caused by deep venous thrombosis, which has the characteristics of sudden and mo...
Moxibustion at Neiguan acupoint in the prevention of myocardial damage caused by chemotherapy in breast cancer
Objective To investigate the effect of moxibustion on Neiguan acupoint in preventing myocardial damage caused by anthracycline-based chemotherapy in breast cancer patients, and to explore the feasibility of moxibustion o...
Efficacy and safety of endoscopic submucosal dissection in the treatment of early cardia cancer and non-cardia cancer with submucosal infiltration
"<b>Objective</b> To analyze the clinicopathological features of submucosal early cardia and non-cardia cancer,and evaluate the efficacy of endoscopic submucosal dissection (ESD) for treating early gastric cancer (EGC)...
Application of artificial intelligence system based on control theory feedback model in ultrasound diagnosis and treatment medical insurance payment
Objective To analyzes the optimization function of artificial intelligence system based on control theory feedback model applied to medical insurance payment. Methods Aiming at the unclear category of ultrasonic diagnosi...