Analysis for High-risk Risk Factors and Construction of a Clinical Prediction Model for Colorectal Serrated Adenoma Progression
10.13241/j.cnki.pmb.2025.17.005
- VernacularTitle:结直肠锯齿状腺瘤进展的高危危险因素分析及临床预测模型构建
- Author:
Hai-qun ZHANG
1
;
Xia LI
;
Hai-yang YANG
;
Hao CHEN
;
Li-guo WANG
Author Information
1. 监利市人民医院消化内科 湖北荆州 433300
- Publication Type:Journal Article
- Keywords:
Serrated adenoma;
Serrated lesions;
Colorectal cancer;
Prediction model
- From:
Progress in Modern Biomedicine
2025;25(17):2759-2767
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the independent risk factors for colorectal serrated adenomas to develop heterogeneous hyperplasia or carcinoma,to construct a clinical prediction model and to evaluate and validate it.Methods:The clinical data characteristics of 737 patients with colorectal serrated adenomas who underwent electronic colonoscopy in the Gastrointestinal Endoscopy Unit of the Fourth Affiliated Hospital of Harbin Medical University were retrospectively analyzed,and they were randomly divided into the training set and the validation set with 515 and 222 cases,respectively,using R software(7∶3),and were classified into the group with no neoplasia according to their histological characteristics The independent risk factors were screened by univariate and multivariate logistic regression analyses and included in the R software,and the predictive model was evaluated using the"RMS"package with column-line plots,using the subjects'work characteristic curves,calibration curves,and decision curves,and then validated using the data from the validation set.Results:1.The incidence of heterogeneous hyperplasia and carcinoma in colorectal serrated adenomas in this study was 31.1%and 1.1%,respectively,and multifactorial logistic regression analysis showed that Age,diameter,and morphology were independent risk factors for the occurrence of heterogeneous hyperplasia or carcinoma in colorectal SA;2.The three independent risk factors of age,diameter,and morphology were applied to establish a column-line diagram,and the model was verified as having clinical predictive value for the occurrence of heterogeneous hyperplasia and carcinoma in serrated adenomas.Conclusions:In this study,age,diameter,and morphology were concluded to be the independent risk factors for the development of heterogeneous hyperplasia and carcinoma in colorectal serrated adenomas,and the column chart constructed on the basis of these factors had clinical predictive value.