基于术前谷草转氨酶构建预测早期胃癌患者淋巴结转移的列线图模型

Construction of a nomogram chart model for predicting lymph node metastasis in early gastric cancer patients based on preoperative glutamic-oxaloacetic transaminase

目的基于术前谷草转氨酶构建预测早期胃癌患者淋巴结转移的列线图模型,并验证其预测价值。方法收集2018月1月—2022年10月在新疆医科大学附属中医医院行胃癌手术治疗的189例患者的临床资料,分析患者一般临床资料、术前谷丙转氨酶水平、术前谷草转氨酶水平、术前血小板和淋巴细胞比值、术前中性粒细胞和淋巴细胞比值、浸润深度、溃疡与早期胃癌淋巴结转移的相关性,多因素Logistic回归分析筛选早期胃癌淋巴结转移的独立预测因素,重点分析术前谷草转氨酶与早期胃癌淋巴结转移的相关性,基于独立预测因子构建列线图模型用于预测早期胃癌淋巴结转移风险,绘制列线图模型的校准曲线验证模型的预测价值。结果多因素Logistic回归分析结果显示:浸润深度、组织类型、术前谷草转氨酶水平、肿瘤大小为早期胃癌淋巴结转移的独立预测因子(P<0.05),OR值及95%CI分别为8.356[5.312,10.655]、2.115[1.265,2.874]、1.888[1.293,4.058]、1.565[2.547,5.873],列线图模型的C指数为0.838,95%CI:[0.775,0.927],经拟合优度检验显示该模型具有较好的校准度(χ^(2)=0.242,P=0.784)。结论结合浸润深度、组织类型、术前谷草转氨酶水平、肿瘤大小构建的列线图模型符合度良好,用于预测早期胃癌患者淋巴结转移风险具有较高的临床应用价值。

Objective To establish a nomogram chart model for predicting lymph node metastasis in early gastric cancer patients based on preoperative glutamic oxaloacetic transaminase,and to verify its predictive value.Methods The clinicopathological data of 189 patients who underwent gastric cancer surgery in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2018 to October 2022 were collected,and correlations between the general clinical data of patients,preoperative glutamic-pyruvic transaminase,preoperative glutamic-oxaloacetic transaminase(GOT),preoperative platelet to lymphocyte ratio,preoperative neutrophil to lymphocyte ratio,infiltration depth,ulcer and lymph node metastasis of early gastric cancer,etc.were analyzed,and multivariate Logistic regression analysis used to obtain independent predictors of lymph node metastasis of early gastric cancer,focusing on the correlation between preoperative GOT and lymph node metastasis of early gastric cancer.A nomogram model was constructed based on independent predictors to predict the risk of lymph node metastasis of early gastric cancer,and a calibration curve of the nomogram model drawn to verify the predictive value of the model.Results Multivariate analysis results showed that invasion depth,tissue type,preoperative GOT and tumor size were independent predictors of lymph node metastasis of early gastric cancer(P<0.05),and OR were 8.356,2.115,1.888 and 1.565,95%CI were[5.312,10.655],[1.265,2.874],[1.293,4.058]and[2.547,5.873]respectively.The C-index of nomogram model was 0.838,95%CI:[0.775,0.927],and the goodness of fit test showed that the model had a good calibration degree(χ^(2)=0.242,P=0.784).Conclusion The nomogram model constructed by combining the invasion depth,tissue type,preoperative GOT,and tumor size has a good agreement,and is of high clinical application value for predicting the risk of lymph node metastasis in patients with early gastric cancer.