西北地区膀胱肿瘤发病危险因素分析及风险预测模型研究

Risk factors analysis and risk prediction model of bladder tumor in Northwest China

目的分析西北地区膀胱肿瘤发病的危险因素并建立风险预测模型。方法选取空军军医大学西京医院和唐都医院2021年7月至2022年9月收治的197例西北地区膀胱肿瘤患者为病例组;另外选取同院同期收治的171例非肿瘤志愿者为对照组。通过问卷和病历系统收集入组者临床资料,包括性别、年龄、体质量指数(BMI)、民族、既往史、服药史、情绪、吸烟、饮酒、饮水量、有害物质接触情况、自我保护意识等。利用t检验、非参数检验或χ^(2)检验,筛选病例组和对照组之间有显著差异的变量,随后对差异变量赋值并进行logistic回归分析,以明确西北地区膀胱肿瘤发病的危险因素,进而对风险因素加权以建立风险预测模型。最后,通过ROC曲线评估预测模型的可信度。结果低学历(本科以下)、急躁/暴躁情绪、长烟龄(≥10年)、长期使用染发剂(≥11年)、自我保护意识较弱、有泌尿系病史、饮水量≤1200 mL/d和体育锻炼≤1次/周均为西北地区膀胱肿瘤发病的危险因素(P<0.05)。基于上述8项危险因素建立的西北地区膀胱肿瘤发病风险预测模型具有较高的预测准确度(AUC=0.906)。结论保持良好生活习惯、控制负性情绪、加强体育锻炼、减少染发剂暴露、增强自我保护意识、积极防治泌尿系疾病是预防膀胱肿瘤发病的有效手段。本研究构建的膀胱肿瘤发病风险预测模型准确度较高,有望用于西北地区膀胱肿瘤筛查。

Objective To analyze the risk factors of bladder tumor in Northwest China and establish the risk prediction model.Methods A total of 197 patients with bladder tumor in Northwest China from July 2021 to September 2022 were selected as the case group from Xijing Hospital and Tangdu Hospital of Air Force Medical University.In addition,171 non-tumor volunteers admitted to the same hospital at the same period were selected as the control group.Clinical data were collected by questionnaire and medical record system,including gender,age,body mass index,ethnicity,previous history,medication history,mood,smoking,alcohol consumption,water intake,exposure to harmful substances,self-protection awareness,etc.The t test,nonparametric test or chi-square test were used to screen variables with significant differences between the case group and the control group,the differential variables were assigned and logistic regression analysis was performed to clarify the risk factors of bladder tumor in Northwest China,and then the risk factors were weighted to establish a risk prediction model.Finally,the reliability of the prediction model was evaluated by ROC curve.Results Low education(below bachelor level),impatient/irritable mood,long smoking age(≥10 years),long-term use of hair dye(≥11 years),weak self-protection awareness,history of urinary system,water intake≤1200 mL/d and physical exercise≤1 time/week were all risk factors of bladder tumor in Northwest China(P<0.05).The risk prediction model of bladder tumor in Northwest China based on the above 8 risk factors had a high prediction accuracy(AUC=0.906).Conclusion Maintaining good living habits,controlling negative emotions,strengthening physical exercise,reducing exposure to hair dye,enhancing self-protection awareness,and actively preventing urinary diseases are effective means to prevent bladder tumors.The risk prediction model of bladder tumor established in this study has high accuracy,which is expected to be used for bladder tumor screening in Northwest China.