METHODS: Information of gastric cancer patients complicated with preoperative anemia in the First Affiliated Hospital of Sun Yat-sen University was collected. The cohort from the First Affiliated Hospital of Guangxi Medical University was used as an external validation set. A Nomogram was established based on the risk factors screened by univariate and multivariate logistic regression analyses.
RESULTS: A total of 848 gastric cancer patients with preoperative anemia were enrolled. Pyloric obstruction, carcinoma antigen 125, T stage, N stage, tumor size, and preoperative weight loss were independent predictors of distant metastasis in gastric cancer patients with anemia (p < 0.05), based on which a nomogram was constructed. The accuracy, reliability and clinical value of the nomogram were evaluated by concordance index, receiver operating characteristic curve, decision curve analysis, calibration curve and showed good stability and clinical predictive value.
CONCLUSIONS: Preoperative anemic gastric cancer patients, complicated with pyloric obstruction, elevated CA125, advanced T and N stage, larger tumor size, and preoperative weight loss, should be paid more attention to distant metastasis.
方法:收集中山大学附属第一医院胃癌合并术前贫血患者的资料。来自广西医科大学第一附属医院的队列作为外部验证集。根据单变量和多变量逻辑回归分析筛选的危险因素建立列线图。
结果:共纳入848例术前贫血胃癌患者。幽门梗阻,癌抗原125,T分期,N级,肿瘤大小,术前体重下降是胃癌伴贫血患者远处转移的独立预测因素(p<0.05),在此基础上构建了一个列线图。准确性,通过一致性指数评估列线图的可靠性和临床价值,接收机工作特性曲线,决策曲线分析,显示良好的稳定性和临床预测价值。
结论:术前贫血胃癌患者,并发幽门梗阻,CA125升高,T和N阶段提前,肿瘤较大,和术前体重减轻,应重视远处转移。