融合中医证候的结直肠癌肝转移微波消融术安全性分析及预后多维预测模型构建

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Abstract：Objective To evaluate the impact traditional Chinese medicine （TCM）syndromes on percutaneous microwave ablation（MWA） treatment inpatients with colorectalcancer liver metastases（CRLM）and to construct a multidimensional prediction model prognostic based on TCM syndrome classification.Methods Clinical data were collected from 86 CRLM patients who underwent MWA at Zhongshan Traditional Chinese Medicine between October 2012 and October 2023.The clinical information covered TCM syndrome types qi 一 blood deficiency and spleen-kidney yang deficiency，tumor characteristics，and treatment parameters.Logistic regression was used to screen feature variables for constructing the prognostic predication model，and cross validation was performed to evaluate the prognostic predictive performance.Results（1） Among the 86 CRLM patients，31（ 36.05% ）had spleen-kidney yang deficiency syndrome， while 55（ 63.95% ）had qi -blood deficiency syndrome.（2）Compared to the patients with spleen-kidney yang deficiency syndrome，patients with （204号 qi -blood deficiency syndrome exhibited significantly long progression-free survival （PFS）and high progressionfree survival rate （ P<0.01 ），while no significant differences were presented in the incidences postoperative adverse events such as pain，fever，infection，liver function impairment，or ascites/pleural efusion among he patients with the two syndrome types （ P>0.05 ）.（3）Multivariate logistic regression analysis revealed that TCM syndrome type，maximum diameter metastatic liver tumor，timing liver metastasis，and Ki-67 expression rate primary tumors were the independent prognostic factors for 1-year PFS（ P<0.05 or P<0.01 ）.（4）The constructed model demonstrated high predictive accuracy for PFS，with an area under the receiver operating characteristic（ROC） curve（AUC） 0.905（95 % CI： 0.830-0.98O）. Conclusion TCM syndromes have significant influence on the prognosis CRLM patients undergoing MWA， and the patients with qi -blood deficiency syndrome have favorable prognosis.This study pioneers a multidimensional prognostic prediction model integrating TCM syndromes for MWA-treated CRLM patients， highlighting the unique value TCM syndromes in assessing disease progression and predicting prognosis.

Keywords： colorectal cancer liver metastases； Traditional Chinese mendicine syndrome type； qi -blooddeficiency syndrome；spleen-kidney yang deficiency syndrome；microwave ablation；multidimensional predictionmodel； prognosis

结直肠癌肝转移（colorectalcancerliver metastases，CRLM是结直肠癌患者常见且严重的远处转移形式之一，其复杂的病理特征和较差的预后使得治疗难度显著增加。（剩余12980字）