Construction of a Nomogram model for personalized prediction of the risk of delayed postoperative bleeding after endoscopic submucosal dissection for early gastric cancer
10.16139/j.1007-9610.2024.03.09
- VernacularTitle:个体化预测早期胃癌内镜黏膜下剥离术后迟发性出血风险的列线图模型构建
- Author:
Tingting GONG
1
;
Aihua QIAN
;
Xi CHEN
Author Information
1. 上海交通大学医学院附属瑞金医院 消化内科,上海 200025
- Keywords:
Early gastric cancer;
Endoscopic submucosal dissection(ESD);
Delayed postoperative bleeding(DPPB);
Influencing factors;
Nomogram
- From:
Journal of Surgery Concepts & Practice
2024;29(3):236-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of delayed postoperative bleeding(DPPB)after endoscopic submucosal dissection(ESD)for early gastric cancer and construct a Nomogram model.Methods The clinical information of 234 patients who underwent ESD treatment at our hospital and pathologically diagnosed with early gastric cancer from April 2021 to April 2023 were collected.The patients were grouped based on the presence or absence of DPPB.Logistic regression analysis was applied to screen for risk factors affecting DPPB after ESD in early gastric cancer patients.R software was applied to construct a Nomogram model for predicting the risk of DPPB in early gastric cancer patients after ESD.Receiver operator characteristic(ROC)curve,calibration curve,and Hosmer-Lemeshow goodness of fit test were plotted to evaluate the Nomogram model.Results A total of 23(9.8%)of 234 early gastric cancer patients who underwent ESD treatment developed DPPB.Multivariate Logistic regression analysis showed that the number of biopsies≥3(95%CI:2.482-20.424,P=0.000),the maximum diameter of lesions≥3 cm(95%CI:1.620-13.244,P=0.004),the depth of invasion to submucosa(95%CI:1.421-10.536,P=0.008),and intraoperative bleeding(95%CI:1.160-11.300,P=0.027)were independent risk factors for DPPB after ESD in early gastric cancer patients.The area under ROC curve(AUC)was 0.838(95%CI:0.743-0.932).The slope of the calibration curve was close to 1.Hosmer-Lemeshow goodness of fit test showed χ2=3.328,P=0.505.Conclusions The number of biopsies≥3,the maximum diameter of lesion≥3 cm,the depth of invasion to submucosa,and intraoperative bleeding are independent risk factors for DPPB after ESD in early gastric cancer patients.The Nomogram model based on these four independent risk factors can effectively predict the risk of DPPB after ESD in early gastric cancer patients.
