Exploration of Risk Factors of Colonic Polyps Recurrence from Toxin-Grime Theory and Construction of the Prediction Model
Objective To investigate the risk factors for the recurrence after endoscopic resection of colonic polyps from the toxin-grime theory proposed by Professor QIU Jian-Xing,and to construct the prediction model for predicting the risk of recurrence.Methods A retrospective analysis was conducted in 383 patients who underwent colonic polypectomy in the Department of Spleen and Stomach of Guangdong Second Traditional Chinese Medicine Hospital from January 2018 to June 2023.All of the patients underwent colonoscopy again during the period of one year to one year and a half after the operation.Of the 383 patients,254 patients relapsed and 129 patients did not relapse.Moreover,the data set of the 383 patients was randomly divided into a training set of 306 cases and a validation set of 77 cases at the ratio of 8 to 2.The risk factors related to the recurrence after colonic polypectomy were analyzed,and a logistic regression prediction model was established for verification.Results(1)In the recurrence-related factor analysis and model construction,logistic regression analysis results showed that related factors for the recurrence of colorectal polyps involved age(OR=1.03),hypertension(OR=2.91),body mass index(BMI)(OR=2.12),improper diet(OR=5.01),history of tobacco and alcohol(OR=2.24),history of use of psychotropic drugs(OR=2.44),damp-heat(OR=4.83),phlegm-retention(OR=3.24),blood stasis(OR=5.17),number of polyps(OR=1.38),diameter of polyps(OR=1.13),and pathological nature of polyps(OR=2.27),the difference being significant(P＜0.05 or P＜0.01).(2)The evaluation of the model showed that the area under the receiver operating characteristic(ROC)curve of the training set was 0.874(95％CI:0.834-0.914),and the area under the ROC curve of the validation set was 0.883(95％CI:0.806-0.961).The calibration curves of the training set and the validation set showed that the prediction accuracy of the model based on the above factors was reliable.(3)The clinical application of the model showed that the risk prediction can be performed by drawing a nomogram,and decision-making basis can be obtained after drawing a clinical decision curve and a clinical impact curve.Conclusion Age,hypertension,BMI,improper diet,history of tobacco and alcohol,history of use of psychotropic drugs,damp-heat,phlegm-retention,blood stasis,number of polyps,diameter of polyps and pathological nature of polyps are risk factors related to the recurrence of colorectal polyps.The prediction model based on the above factors has good discrimination and calibration,and can predict the probability of recurrence of colon polyps.
toxin-grime theorycolonic polypsrisk factorsdamp-heatphlegm-retentionblood stasislogistic regression analysisprediction model
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