摘要
目的探究非Ⅰ期子宫内膜癌手术患者术后复发的危险因素并构建风险预测模型。方法选取2016年5月至2018年5月浙江萧山医院收治的158例非Ⅰ期子宫内膜癌手术患者作为研究对象,根据术后复发情况分为复发组(n=30)和未复发组(n=128)。比较两组患者的基线资料,采用单因素及多因素Logistic回归分析影响患者术后复发的因素,构建列线图预测模型,分别采用校准曲线和临床决策曲线评价模型预测的准确性和有效性。结果年龄≥60岁、有脉管癌栓、肌层浸润深度≥1/2肌层、非子宫内膜样腺癌、组织学分级G3、临床分期Ⅲ~Ⅳ期、未行腹主动脉旁淋巴结清扫、术后未行放疗或化疗均是影响非Ⅰ期子宫内膜癌手术患者术后复发的危险因素;构建的列线图模型预测患者术后复发的准确性和有效性较好,具有较高的预测价值。结论在临床工作中,早期识别非Ⅰ期子宫内膜癌患者术后复发的危险因素,可为术后辅助治疗方案的制定提供参考,有利于降低患者的术后复发率,提高患者的预后水平。
Objective To explore the risk factors of postoperative recurrence in patients with non-stageⅠendometrial carcinoma and to construct a risk prediction model.Methods 158 patients with non-stageⅠendometrial carcinoma treated in Zhejiang Xiaoshan Hospital from May 2016 to May 2018 were divided into recurrent group(n=30)and non-recurrent group(n=128)according to postoperative recurrence.The baseline data of the two groups were compared.Univariate and multivariate Logistic regression were used to analyze the influencing factors of postoperative recurrence.The nomogram prediction model was constructed,and the calibration curve and clinical decision curve were used to evaluate the accuracy and validity of the prediction model.Results Age≥60 years old,vascular tumor thrombus,myometrial invasion≥1/2 myometrium,non-endometrioid adenocarcinoma,histological grade G3,clinical stageⅢ~Ⅳ,no para-aortic lymph node dissection,no postoperative radiotherapy or chemotherapy are all risk factors for postoperative recurrence of non-stageⅠendometrial carcinoma.The constructed nomogram model has good accuracy and effectiveness in predicting postoperative recurrence,and has high predictive value.Conclusions In clinical work,early identification of risk factors for postoperative recurrence of patients with non-stageⅠendometrial cancer can provide reference value for the formulation of postoperative adjuvant treatment,which is helpful to reduce the postoperative recurrence rate and improve the prognosis of patients.
作者
张敏
ZHANG Min(Department of Gynecology,Zhejiang Xiaoshan Hospital,Hangzhou 311200,Zhejiang,China)
出处
《中国性科学》
2022年第8期110-114,共5页
Chinese Journal of Human Sexuality
关键词
非Ⅰ期子宫内膜癌
术后复发
危险因素
列线图预测模型
Non-stageⅠendometrial carcinoma
Postoperative recurrence
Risk factors
Nomogram prediction model
