Application of a nomogram model based on endorectal ultrasound features and tumor markers for preoperative prediction of lymph node metastasis in rectal cancer
10.3760/cma.j.cn131148-20250612-00313
- VernacularTitle:基于直肠腔内超声特征及肿瘤标记物的列线图模型术前预测直肠癌淋巴结转移
- Author:
Lirui WANG
1
;
Guozhu WU
1
Author Information
1. 内蒙古自治区人民医院超声医学科，呼和浩特 010017
- Publication Type:Journal Article
- Keywords:
Rectal cancer;
Lymph node metastasis;
Endorectal ultrasound;
Nomogram
- From:
Chinese Journal of Ultrasonography
2025;34(10):841-847
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for lymph node metastasis（LNM）in rectal cancer and to construct a nomogram model for predicting the risk of LNM.Methods:The data of 106 patients with rectal cancer who were confirmed after radical surgery at the Inner Mongolia Autonomous Region People's Hospital from January 2023 to October 2024 was retrospectively analyzed. Based on postoperative pathological results，patients were divided into LNM-positive group（50 cases）and LNM-negative group（56 cases）. Clinical and ultrasound imaging data were compared between the two groups. Multivariate Logistic regression analysis was used to identify independent risk factors for LNM in rectal cancer patients. A nomogram prediction model was constructed based on statistically significant risk factors，and the model was verified by the ROC curve，calibration curve and DCA curve.Results:Multivariate Logistic regression analysis revealed that preoperative endorectal ultrasound（ERUS）- diagnosed T stage（uT），LNM status（uN），extramural vascular invasion status（ER-EMVI），and the tumor marker carcinoembryonic antigen（CEA）were independent risk factors for LNM in rectal cancer（all P<0.05）. The nomogram prediction model based on these indicators demonstrated excellent predictive performance，with an area under the curve of 0.835（95% CI=0.761 - 0.909）. Calibration curve analysis indicated a high consistency between the model's predictions and actual outcomes. Furthermore，the DCA confirmed that the nomogram model provided significant net benefits in clinical applications. Conclusions:The nomogram model constructed based on preoperative ERUS features（uT，uN，ER-EMVI）and tumor marker CEA can effectively assess the probability of LNM in rectal cancer patients，providing valuable support for clinical decision-making.
