首页|胃癌术后辅助化疗期间恶心呕吐风险预测模型的建立及验证

胃癌术后辅助化疗期间恶心呕吐风险预测模型的建立及验证

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目的 探讨胃癌病人手术后化疗期间恶心呕吐的风险因素,并构建相应的风险预测模型.方法 2020年2月~2021年2月收治的胃癌病人作为建模集组,用于探讨胃癌病人手术后化疗期间恶心呕吐的风险因素,并构建相应的风险预测模型,将2021年3月~2022年2月(第1年)、2022年3月~2023年2月(第2年)、2023年3月~2024年2月(第3年)作为验证集组用于验证建模集组构建的风险预测模型.统计建模集组病人化疗期间呕吐发生情况.采用单因素和多因素Logistic回归分析胃癌病人手术后化疗期间恶心呕吐风险因素,并构建相应的风险预测模型.采用受试者工作特征曲线(receiver operating characteristic curve,ROC)以 2021 年 3 月~2024年2月3年的验证集验证列线图预测模型的准确性.结果 建模集组共纳入112例,其中 75例未发生化疗相关性恶心呕吐,纳入对照组,37例病人发生了化疗相关性恶心呕吐,纳入观察组.单因素分析显示,年龄、性别、饮酒史、晕动病史、化疗次数、既往化疗相关性恶心呕吐史、妊吐史、匹茨堡睡眠质量指数(PSQI)、心理预期发生化疗后恶心呕吐等与病人发生化疗相关性恶心呕吐有关(P<0.05).将单因素分析得到具有统计学意义的因素进行Logistic回归分析,结果显示,年龄、性别、晕动病史、化疗次数、妊吐史、PSQI、心理预期发生化疗后恶心呕吐是胃癌病人术后化疗期间恶心呕吐的危险因素(P<0.05).根据Logistic回归得到具有统计学意义的因素构建风险预测模型.使用Bootstrap法对模型进行内部验证,第1年验证集组ROC曲线下面积(AUC)为0.71(95%CI:0.71~1.00),第 2 年验证集组 0.69(95%CI:0.58~0.96),第 3 年验证集组 0.66(95%CI:0.54~0.95).结论 年龄、性别、晕动病史、化疗次数、妊吐史、PSQI、心理预期发生化疗后恶心呕吐是胃癌病人术后化疗期间恶心呕吐的危险因素,上述因素构建的胃癌病人化疗期间恶心呕吐的风险预测模型具有较好的预测效能.
Establishment and validation of a risk prediction model for nausea and vomiting during postoperative chemotherapy in gastric cancer patients
Objective To investigate the risk factors of nausea and vomiting during postoperative chemotherapy in patients with gastric cancer and to construct a corresponding risk prediction model.Methods This study collected gastric cancer patients from the first affiliated hospital of Hunan university of traditional Chinese medicine from February 2020 to February 2021 as a modeling set to explore the risk factors of nausea and vomiting during chemotherapy in gastric cancer patients after surgery,and constructed a corresponding risk prediction models.The data were collected from March 2021 to February 2022(Year 1),March 2022 to February 2023(Year 2),and March 2023 to February 2024(Year 3)as a validation set,which was used to validate the risk prediction model constructed by the modeling set.The incidence of vomiting during chemotherapy was detected in the modeling set.The univariate and multivariate Logistic regression to analyze the risk factors of nausea and vomiting during chemotherapy in gastric cancer patients after surgery,and constructing a corresponding risk prediction model.The accuracy of the corresponding risk prediction model was validated using receiver operating characteristic curve(ROC)with a validation set from March 2021 to February 2024.Results A total of 112 patients were included in the modeling set,of which 75 patients(66.96%)did not have nausea and vomiting during postoperative chemotherapy and were included in the control group,while 37 patients(33.04%)developed nausea and vomiting during postoperative chemotherapy and were included in the observation group.The univariate analysis showed that age,gender,history of alcohol consumption,history of motion sickness,frequency of chemotherapy,history of chemotherapy-related nausea and vomiting,history of vomiting during pregnancy,Pittsburgh sleep quality index(PSQI)and psychological expectation of post chemotherapy nausea and vomiting were related to the occurrence of nausea and vomiting during postoperative chemotherapy(P<0.05).Logistic regression analysis showed that age,gender,history of motion sickness,chemotherapy frequency,history of vomiting during pregnancy,PSQI,and psychological expectation of postoperative nausea and vomiting in gastric cancer patients were risk factors for nausea and vomiting during postoperative chemotherapy(P<0.05).A risk prediction model based on Logistic regression to identify statistically significant factors.Internal validation of the model was conducted by the Bootstrap method,with an area under curve(AUC)of 0.71(95%CI:0.71-1.00)for the first year validation set,0.69(95%CI:0.58-0.96)for the second year validation set,and 0.66(95%CI:0.54-0.95)for the third year validation set.Conclusion The Age,gender,history of motion sickness,frequency of chemotherapy,history of vomiting during pregnancy,PSQI and psychological expectation of postoperative nausea and vomiting during chemotherapy are risk factors for nausea and vomiting during postoperative chemotherapy.The risk prediction model for nausea and vomiting during chemotherapy in gastric cancer patients constructed based on the above factors has good predictive performance and can provide reference for clinical treatment of gastric cancer patients.

gastric cancerchemotherapynauseavomitingrisk prediction model

张慧、张萍、郭汝、何娅娜

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410007 长沙,湖南中医药大学第一附属医院神经内科

410007 长沙,湖南中医药大学第一附属医院血液肿瘤科

410007 长沙,湖南中医药大学第一附属医院胃肠外科

410007 长沙,湖南中医药大学第一附属医院教育教学与研究生工作部

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胃癌 化疗 恶心呕吐 风险预测模型

湖南省中医药科研项目

HN-LL-KY-2023-005-01

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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