摘要
目的 构建乳腺癌术后发生切口感染的列线图预警模型并进行验证。方法 回顾性收集2020年1月至2024年10月877例乳腺癌患者的临床数据,按照7∶3的比例分为训练集(n=614)和验证集(n=263)。采用单因素和多因素Logistic回归模型分析乳腺癌术后切口感染的危险因素,采用R软件构建列线图模型并进行内外部验证。结果 训练集614例乳腺癌患者中,发生术后切口感染52例(8.5%)。Logistic多因素分析显示,手术时间>2 h、普通负压引流、引流时间≥10天、术后化疗和白蛋白≤35 g/L为影响乳腺癌术后发生切口感染的独立危险因素(P<0.05)。列线图模型显示,手术时间>2 h为86分、普通负压引流为98分、引流时间≥10天为82分、术后化疗为100分、白蛋白≤35 g/L为84分。模型验证显示,C-index为0.838,校正曲线趋近于理想曲线,曲线下面积为0.815。结论 构建的列线图模型可准确量化乳腺癌术后发生切口感染的风险,满足临床上对于整合模型的需求。
Objective To construct a nomogram for incisional infections occurring after breast cancer surgery and further validate the model.Methods The data of 877 breast cancer patients admitted from January 2020 to October 2024 were retrospectively extracted and divided into training set(n=614)and validation set(n=263)according to the ratio of 7∶3.The risk factors of postoperative incisional infection in breast cancer were analyzed by using univariate and multivariate Logistic regression,and the nomogram was constructed and internally and externally validated by using R software.Results In the 614 patients with postoperative breast cancer of training set,incisional infection was occurred in 52 patients(8.5%).Surgery time>2 h,normal negative pressure drainage,drainage time≥10 d,postoperative chemotherapy and albumin≤35 g/L were independent risk factors for postoperative incisional infection for breast cancer(P<0.05).The model of the nomgram showed that 86 points for surgery time>2 h,98 points for normal negative pressure drainage,82 points for drainage time≥10 d,100 points for postoperative chemotherapy,and 84 points for albumin≤35 g/L.The model validation showed a C-index of 0.838,and the calibration curve tended to be close to the ideal curve with an area under the curve of 0.815.Conclusion The constructed nomogram model can accurately quantify the risk of incisional infection after breast cancer surgery,which meets the clinical needs for an integrated model.
作者
练亚琴
杨炜娟
胡晶晶
朱晓玉
王荣荣
LIAN Yaqin;YANG Weijuan;HU Jingjing;ZHU Xiaoyu;WANG Rongrong(Department of Breast Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《临床肿瘤学杂志》
2025年第1期38-43,共6页
Chinese Clinical Oncology
关键词
乳腺癌
切口感染
预测
危险因素
列线图模型
Breast cancer
Incisional infection
Prediction
Risk factors
Nomogram model
