基于息肉特征和血清学指标构建结直肠息肉复发风险预测模型及效能分析

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中图分类号：R574.62，R574.63 文献标志码：A DOI：10.11958/20252207

Abstract：ObjectiveTo develop a recurrence risk prediction model forcolorectal polyps based on polyp characteristicsandserologicalindicators，mingtoimproveearlyrecognitioncolorectalpolyprecurrenceandpesoalized treatment.MethodsAretrospectiveanalysiswasconductedonclinicaldatafrom235 patientswhounderwentcolorectal polypresection.Basedonwhetherrecurrenceoccurred，the patients were divided into the recurence group （56cases）and thenon-recurencegroup（179cases）.Clinicaldata，polypcharacteristicsandrelatedserologicalindicatorswerecollcted. Logistic regressionanalysis wasused to identify independent predictors forcolorectal polyprecurrnce.Basedontheresults Logisticregresson，anomogram modelforpredictingcolorectalpolyprecurencerisk wasconstructed，andthemodel's predictive performance was evaluated using ROCand calibration curves.ResultsCompared with thenon-recurrence group，therecurrencegrouphadhigherage，male proportion，bodymassindex （BMI），familyhistoryproportion，polypsize， proportion adenomatous polyps，proportion high-grade lesions，and elevated serum levels carcinoembryonic antigen （CEA） and C-reactive protein （CRP）（ P<0.05 ）.Logistic regression analysis showed that age （ OR=1.032 ， 95%CI： 1.003- 1.062），BMI （ OR=1.064 ，95%CI： 1.000-1.131）， family history （ OR=2.34 ， 95%CI： 1.039-5.267），high-grade pathological lesions （ OR=6.323 ，95%CI： 2.184-18.430）， polyp size （ OR=3.161 ，95%CI： 1.434-6.965）， CEA （ OR=1.486 ，95%CI： 1.160-1.904）， and CRP（ OR=1.132 ， 95%CI： 1.022-1.254） were important predictors for colorectal polyp recurrence.Based onthesefactors，anomogrammodelforpredictingcolorectalpolyprecurrencerisk wasconstructed.Model evaluationshowed that the nomogram had an area under the curve （AUC） 0.893 （95%CI： 0.836 - 0.950）， sensitivity 81.6% ， specificity （20号 87.5% ，and good discrimination and calibration （Hosmer-Lemeshow χ2=2.396 ， P=0.743 ）. Conclusion The recurrence risk predictionmodelbasedonpolypcharacteristicsandserologicalindicators developed inthisstudy hashighpredictive efficacy and can effectively assess the risk colorectal polyp recurence.

KeyWords： intestinal polyposis; recurrence; nomograms; polyp characteristics; serological indicators

近年来，结直肠癌（CRC）已成为全球范围内较为常见的恶性肿瘤之一，且其发病率逐年上升[1-2]。（剩余10495字）