1.Construction and validation of a prediction model for pyloric lymph node metastasis in upper gastric cancer
Zhisheng MA ; Zhaoyu SONG ; Peifeng CHEN ; Wannian SUI ; Zhangming CHEN ; Wenxiu HAN
Acta Universitatis Medicinalis Anhui 2026;61(2):328-334
ObjectiveTo identify the independent risk factors for pyloric lymph node (PLN) metastasis in patients with upper gastric cancer (UGC) and to construct a nomogram prediction model applicable for UGC patients. MethodsClinical data of 823 UGC patients attended between January 2020 and November 2023 were retrospectively collected. Patients were randomly divided into a training set (n=576) and a validation set (n=247) at a 7∶3 ratio. Based on the training set, multivariate Logistic regression analysis was performed to identify independent risk factors for PLN metastasis, and a nomogram prediction model was constructed accordingly. The model's discriminative ability and calibration were assessed using receiver operating characteristic (ROC) curves and calibration curves. Finally, external validation was conducted using the validation set to evaluate the model's stability and generalizability. ResultsMultivariate Logistic regression analysis revealed that tumor size (OR=1.324, 95%CI: 1.053-1.667), T3 stage (OR=5.738, 95%CI: 1.281-25.695), T4 stage (OR=7.680, 95%CI: 1.542-38.247), lymphovascular invasion (LVI) (OR=6.623, 95%CI: 1.384-31.708), differentiation extent (OR=3.108, 95%CI: 1.545-6.251), and fibrinogen degradation product (FDP) level (OR=4.849, 95%CI: 2.071-11.355) were independent risk factors for PLN metastasis in UGC patients.The nomogram model constructed based on these factors demonstrated areas under the ROC curve (AUC) of 0.815 (95%CI: 0.751-0.815) in the training set and 0.832 (95%CI: 0.731-0.933) in the validation set. Calibration curves indicated good agreement between predicted and observed outcomes. ConclusionThis nomogram prediction model exhibits good predictive performance for assessing the risk of PLN metastasis in UGC patients.
2.Analysis of risk factors influencing the overall survival and establishment of nomogram predicting model in patients with rectal cancer at T1 and T2 stage
Peifeng Chen ; Wenxiu Han ; Zhangming Chen ; Chuanhong Li ; Wannian Sui
Acta Universitatis Medicinalis Anhui 2022;57(12):2002-2006
Objective :
To explore the independent risk factors affecting the prognosis,and to construct a nomogram model predicting overall of patients with rectal cancer at T1 and T2 stage.
Methods :
Retrospective analysis was made on the data of 353 patients diagnosed as rectal cancer,who received the radical rectal resection.The collect- ed data were as follows : age,body mass index (BMI) ,carcinoembryonic antigen ( CEA) ,tumor size,histological type,T stage,N stage,tumor location and number of lymph nodes detected,which were used to perform Kaplan- Meier curve and Log-rank test for univariate analysis and Cox regression for multivariate analysis.The nomogram model was established to predict the overall survival of patients.
Results :
Age≥60 years,Mucinous adenocarcino- ma,poorly differentiation ,T2 stage ,lymph node metastasis ,BMI ≥25 kg / m2 ,CEA ≥5 μg / L and number of lymph nodes detected <12 were associated with overall survival of patients with rectal cancer at T1 and T2 stage (all P<0. 05) .Cox regression showed that age≥60 years,T2 stage,mucinous adenocarcinoma,lymph node me- tastasis,CEA≥5 μg / L,BMI ≥25 kg / m2 and lymph node detection number <12 were independent risk factors. Based on the above independent risk factors,the nomogram model was constructed,and the predicted curve was in good agreement with the actual survival curve ( C-index = 0. 779) .
Conclusion
Age≥60 years,T2 stage,mucin- ous adenocarcinoma,lymph node metastasis,CEA≥5 μg / L,BMI≥25 kg / m2 and the number of lymph nodes de- tected <12 are independent risk factors ,and the nomogram established in this study can effectively predict the prognosis of patients with rectal cancer at T1 and T2 stage.


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