摘要
目的探讨早期上皮性卵巢癌(EOC)患者腹腔镜术后复发的危险因素及风险预测模型构建。方法回顾性分析2017年3月至2018年3月信阳市人民医院妇产科收治的114例接受腹腔镜全面分期手术治疗的早期EOC患者临床资料,根据患者腹腔镜全面分期术后复发情况分为复发组和未复发组,比较两组临床资料,采用多因素logistic回归分析早期EOC患者腹腔镜全面分期术后复发的危险因素,构建风险预测模型,绘制受试者工作特征(ROC)曲线评估风险模型的预测效能。结果随访5 a,114例经腹腔镜分期术治疗的早期EOC患者中复发50例,复发率为43.86%。两组分化程度、术前糖类抗原125(CA125)、人附睾蛋白4(HE4)、人血清白蛋白(ALB)水平比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,分化程度、术前CA125、HE4、ALB水平是早期EOC患者腹腔镜术后复发的危险因素(P<0.05)。构建风险模型,验证模型显示C-index值为0.856,具有良好区分度,绘制标准曲线显示,校准曲线和Y-X直线相近,模型准确度良好。对模型预测效能进行验证,结果显示,风险模型评估早期EOC患者腹腔镜术后复发的曲线下面积(AUC)为0.856,AUC的95%CI为0.783~0.929,P<0.001,敏感度0.760,特异度0.875,约登指数0.635,说明该风险预测模型具有良好的预测效能。结论早期EOC患者腹腔镜术后的复发率较高,其中分化程度、术前CA125、HE4、ALB水平均是早期EOC患者腹腔镜术后复发的危险因素,基于以上危险因素构建的风险预测模型对早期EOC腹腔镜术后复发有较高的预测价值。
Objective To explore the risk factors and risk prediction model construction of postoperative recurrence in early epithelial ovarian cancer(EOC)patients undergoing laparoscopic surgery.Methods Retrospective analysis was made on the clinical data of 114 patients with early EOC who were treated by the Department of Obstetrics and Gynecology of Xinyang People’s Hospital from March 2017 to March 2018,and were divided into recurrence group and non recurrence group according to the recurrence after laparoscopic comprehensive staging.The clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the risk factors of recurrence in patients with early EOC after laparoscopic comprehensive staging.The risk prediction model was constructed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy of the risk model.Results Following up for 5 years,50 out of 114 early EOC patients treated with laparoscopic staging experienced recurrence,with a recurrence rate of 43.86%.There was a statistical significant difference in differentiation degree,preoperative carbohydrate antigen 125(CA125),human epididymal protein 4(HE4),and serum albumin(ALB)levels between the two groups(P<0.05).Through multivariate logistic regression analysis,the results showed that differentiation degree,preoperative CA125,HE4,and ALB levels were all risk factors for postoperative recurrence in early EOC patients after laparoscopic surgery(P<0.05).The risk model was constructed,and the verification model showed that the C-index value was 0.856,which had good discrimination.The standard curve was drawn,and the calibration curve was similar to the Y-X straight line,and the model accuracy was good.The predictive efficacy of the model was verified.The results showed that the area under the curve(AUC)of the risk model to assess the recurrence of early EOC patients after laparoscopy was 0.856,the 95%CI of AUC was 0.783-0.929,P<0.001,the sensitivity was 0.760,the specificity was 0.875,and the Youden’s J statistic index was 0.635.This indicated that the risk prediction model had good predictive performance.Conclusion Early EOC patients have a higher recurrence rate after laparoscopic surgery,among which differentiation,preoperative CA125,HE4,and ALB levels are all risk factors for recurrence in early EOC patients after laparoscopic surgery.The risk prediction model constructed based on the above risk factors has high predictive value for early EOC recurrence after laparoscopic surgery.
作者
梅金枝
MEI Jinzhi(Department of Obstetrics and Gynecology,Xinyang People’s Hospital,Xinyang 464000,China)
出处
《河南医学研究》
2025年第12期2183-2186,共4页
Henan Medical Research
关键词
上皮性卵巢癌
腹腔镜全面分期术
复发
危险因素
风险构建
epithelial ovarian cancer
laparoscopic comprehensive staging surgery
recurrence
risk factor
risk building
