子宫内膜癌患者机器人腹腔镜术后淋巴囊肿发生危险因素分析及预测模型
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广西省卫生计生委科研课题计划项目(Z20190943)


Analysis and prediction model of risk factors of lymphatic cysts after robotic laparoscopic endometrial cancer
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    摘要:

    目的 探讨子宫内膜癌(EC)患者机器人腹腔镜术后淋巴囊肿发生的危险因素并构建相关预测模型,为术后预防淋巴囊肿提供参考依据。方法 选取2018年3月~2020年12月我院收治的238例EC患者为研究对象,均实行机器人腹腔镜术。采用单因素和多因素Logistic回归分析对术后淋巴囊肿发生的危险因素进行分析并构建预测模型。结果 术后发生淋巴囊肿75例(淋巴囊肿组),未发生淋巴囊肿163例(非淋巴囊肿组),术后淋巴囊肿发生率为31.51%。单因素分析显示,两组患者FIGO分期、引流方式、血清白蛋白水平、淋巴结清扫数目、术后24 h引流量、术后化疗和(或)放疗差异有统计学意义(P<0.05)。多因素分析显示,FIGO分期、引流方式、血清白蛋白水平、淋巴结清扫数目、术后24 h引流量、术后化疗和(或)放疗是术后发生淋巴囊肿的独立影响因素(P<0.05)。 术后淋巴囊肿的预测模型为Logit(P)=-2.578+1.035X1+1.759X2-0.264X3+1.952X4+2.041X5+1.528X6。模型预测术后发生淋巴囊肿的ROC曲线下面积为0.921(95%CI:0.908~0.984),灵敏度为91.20%,特异度为87.40%。模型拟合优度检验显示,x2=8.312(P>0.05)。结论 FIGO分期、引流方式、血清白蛋白水平、淋巴结清扫数目、术后24 h引流量、术后化疗和(或)放疗是EC患者机器人腹腔镜术后发生淋巴囊肿的独立影响因素,据此构建的预测模型具有较好的区分度和校准度,可有效评估术后淋巴囊肿的风险。

    Abstract:

    Objective To investigate the risk factors for the occurrence of lymphatic cysts after robotic laparoscopic endometrial cancer and construct relevant prediction models to provide a reference for the prevention of lymphatic cysts after surgery. Methods A total of 238 endometrial cancer patients admitted to our hospital from March 2018 to December 2020 were selected as the research objects, and they all performed robotic laparoscopic surgery for endometrial cancer. Single factor and multivariate Logistic regression analysis were used to analyze the risk factors of lymphatic cysts after robotic laparoscopic endometrial cancer and construct a predictive model. Results 75 cases of lymphatic cysts occurred after operation, 163 cases did not occur, and the incidence rate of lymphatic cysts after operation was 31.51%. Univariate analysis showed that there were statistically significant differences in FIGO staging, drainage mode, serum albumin level, number of lymph node dissections, postoperative 24 h drainage volume, postoperative chemotherapy and / or radiotherapy between the two groups (P<0.05). Multivariate analysis showed that FIGO staging, drainage mode, serum albumin level, number of lymph node dissections, drainage volume at 24 h after operation, postoperative chemotherapy and/or radiotherapy were independent influencing factors for lymphocele after robotic laparoscopic surgery for endometrial cancer (P<0.05). The prediction model of lymphatic cyst after robotic laparoscopic surgery for endometrial cancer is Logit(P)=-2.578+1.035X1+1.759X2-0.264X3+1.952X4+2.041X5+1.528X6. The area under ROC curve predicted by the model was 0.921 (95%CI :0.908~0.984),the sensitivity was 91.20%,and the specificity was 87.40%. The goodness of fit test showed that χ2=8.312 (P>0.05). Conclusion FIGO stage, drainage mode, serum albumin level, number of lymph node dissection, drainage volume 24h after surgery, postoperative chemotherapy and/or radiotherapy were independent influencing factors for lymphocyst after robotic laparoscopic surgery for endometrial cancer. The prediction model constructed based on these factors had good discrimination and calibration, which could effectively evaluate the risk of lymphocyst after surgery.

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  • 在线发布日期: 2022-09-20
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