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Abstract：
Esophageal stricture is a common complication after endoscopic submucosal dissection (ESD) for superficial esophageal cancer and precancerous lesions, we intend to investigate the independent risk factors of esophageal stricture after ESD by adding the data of included living habits, established a nomogram model to predict the risk of esophageal stricture, and verified it by external data. The clinical data and living habits of patients with early esophageal cancer and precancerous lesions who underwent ESD in the Affiliated Hospital of North Sichuan Medical College and Langzhong People\'s Hospital from March 2017 to August 2021 were retrospectively collected. The data collected from the two hospitals were used as the development group (n = 256) and the validation group (n = 105), respectively. Univariate and multivariate logistic regression analyses were used to determine independent risk factors for esophageal stricture after ESD and establish a nomogram model for the development group. The prediction performance of the nomogram model is internally and externally verified by calculating C-Index and plotting the receiver operating characteristic curve (ROC) and calibration curve, respectively. The results showed that Age, drinking water temperature, neutrophil-lymphocyte ratio, the extent of esophageal mucosal defect, longitudinal diameter of resected mucosa, and depth of tissue invasion (P < 0.05) were independent risk factors for esophageal stricture after ESD. The C-Index of the development group and validation group was 0.925 and 0.861, respectively. The ROC curve and area under the curve (AUC) of the two groups suggested that the discrimination and prediction performance of the model were good. The two groups of calibration curves are consistent and almost overlap with the ideal calibration curve, indicating that the predicted results of this model are in good agreement with the actual observed results. In conclusion, this nomogram model has a high accuracy for predicting the risk of esophageal stricture after ESD, providing a theoretical basis for reducing or avoiding esophageal stricture and guiding clinical practice.
摘要：
食管狭窄是内镜黏膜下剥离术(ESD)治疗浅表性食管癌及癌前病变后常见的并发症,我们拟通过添加纳入的生活习惯数据,探讨ESD术后食管狭窄的独立危险因素,建立了预测食管狭窄风险的列线图模型,并通过外部数据进行验证。回顾性收集2017年3月至2021年8月在川北医学院附属医院、廊中市人民医院行ESD治疗的早期食管癌及癌前病变患者的临床资料和生活习惯。从两家医院收集的数据被用作开发组（n=256）和验证组（n=105），分别。采用单因素和多因素logistic回归分析确定ESD术后食管狭窄的独立危险因素，并建立发展组的列线图模型。通过计算C-Index并绘制接收器工作特性曲线（ROC）和校准曲线，对列线图模型的预测性能进行了内部和外部验证，分别。结果表明,年龄,饮用水温度,中性粒细胞-淋巴细胞比率，食管粘膜缺损的程度，切除粘膜纵径,组织浸润深度(P<0.05)是ESD术后食管狭窄的独立危险因素。开发组和验证组的C指数分别为0.925和0.861。两组的ROC曲线和曲线下面积(AUC)表明模型的判别和预测性能良好。两组校正曲线一致,与理想校正曲线几乎重叠,表明该模型的预测结果与实际观测结果吻合良好。总之,该列线图模型对预测ESD术后食管狭窄的风险具有较高的准确性,为减少或避免食管狭窄和指导临床实践提供理论依据。
