Risk prediction and prevention of upper gastrointestinal bleeding after TACE opera-tion for primary liver cancer
Objective To explore the establishment and prevention of risk prediction diagram model of upper gastro-intestinal bleeding after transcatheter arterial chemoembolization(TACE)surgery for primary liver cancer.Methods A total of 100 liver cancer patients who underwent TACE in our hospital from May 2019 to Dec.2020 were selected.Based on the occurrence of postoperative gastrointestinal bleeding,patients were divided into bleeding group(n=47)and non-bleeding group(n=53).General data between the two groups were compared.Logistic regression analysis was used to identify factors associated with upper gastrointestinal bleeding after TACE.Logistic regression analysis was performed on the bleeding factors based on the Nomogram model to analyze the prognosis and survival of patients with gastrointestinal bleeding.Results Among 100 liver cancer patients,47 had gastrointestinal bleeding after TACE,and 53 did not.There were no significant differences in gender,age,body weight,BMI and pathological classification between the two groups(P＞0.05).There were significant differences in tumor diameter,differentiation degree,microvascular invasion,penetration of liver capsule,surgical margin,intraoperative abdominal fluid,Child-Pugh classification,varicose veins,intubation location,total portal blocking time,tumor number and intestinal sound enhancement(P＜0.05).Binary Lo-gistic regression analysis indicated that tumor diameter,differentiation degree,microvascular invasion,penetration of liver capsule,intraoperative abdominal fluid,Child-Pugh classification,varicose veins,intubation location,tumor num-ber and enhanced intestinal sound were all risk factors for postoperative gastrointestinal bleeding(P＜0.05).The results showed that AUC was 0.863(95％CI:0.808-0.929),sensitivity was 69.58％,specificity was 85.45％.The 2-year survival rate of patients with gastrointestinal hemorrhage was 61.70％(29/47).The 2-year survival rate of patients with no gastrointestinal bleeding was 84.91％(45/53),and there was a statistical difference between the two groups(x2=7.157,P=0.007).Conclusion The construction of risk prediction diagram model is avaluable for predicting and prognosis assessment of upper gastrointestinal bleeding in patients with primary liver cancer after TACE surgery.
Primary liver cancerTranscatheter arterial chemoembolizationUpper gastrointestinal bleedingRisk predictionNomogram model
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