在炎症性肠病中先进结肠直肠新生病的动态预测
Anouk M Wijnands1, Bas B L Penning de Vries2, Maurice W M D Lutgens3
1Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.
一种新的动态预测模型有助于在结肠镜监测期间识别炎症性肠病 (IBD) 患者的晚期结肠直肠瘤 (aCRN) 风险. 这种工具有助于预测癌症风险,改善患者管理.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 生物统计学 生物统计学
背景情况:
- 患有炎症性肠病 (IBD) 的患者患结直肠癌 (CRC) 的风险较高.
- 结肠镜监测对于在IBD患者中早期检测CRC至关重要.
- 预测晚期结直肠瘤 (aCRN) 风险对于个性化监测策略至关重要.
研究的目的:
- 开发和验证IBD患者aCRN的动态预测模型.
- 在结肠镜监测期间确定CRN发生的关键预测因子.
- 评估模型在不同群体中的性能和通用性.
主要方法:
- 来自6项国际队列研究 (n=3731) 的数据汇总.
- 使用地标方法和Cox比例危险建模开发动态预测模型.
- 通过Harrell的协同统计 (歧视) 和校准曲线对模型性能进行评估,并进行内部和外部交叉验证以获得通用性.
主要成果:
- 该模型结合了8个预测因素,并证明了良好的歧视 (五年和十年窗口的平均一致性统计值为0.74-0.75).
- 校准图表显示了模型的良好校准.
- 内部-外部交叉验证显示了适度的歧视和在队列之间合理到良好的校准.
结论:
- 开发的动态预测模型显示了在IBD患者中预测aCRN的前景.
- 模型的通用性有所不同,需要进一步的外部验证.
- 未来的研究应该集中在临床应用上,将预测的风险与监测间隔联系起来.
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