在早期食道癌的内镜下膜剖析后预测出血的临床价值
1Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China.
World journal of gastrointestinal surgery
|December 8, 2025
概括
对于食道癌的内镜下粘膜解剖 (ESD) 后的术后出血是令人担忧的. 一种渐变增强机 (GBM) 模型,结合瘤大小,手术出血和C-反应蛋白,有效预测这种风险.
科学领域:
- 胃肠病学和内镜检查
- 在瘤学瘤学.
- 机器学习在医学中的应用
背景情况:
- 食道癌的发病率很高,预后不佳.
- 内镜下粘膜切割 (ESD) 是早期食道癌的关键最小侵入性治疗方法.
- 手术后出血是一个重要的并发症,可以降低ESD的疗效.
研究的目的:
- 为了确定早期食道癌的ESD后出血相关的危险因素.
- 开发和评估一个梯度增强机 (GBM) 模型,用于预测ESD后手术后出血.
主要方法:
- 对178名早期食道癌患者进行ESD的临床数据的回顾性分析.
- 使用单变量和多变量逻辑回归识别风险因素.
- 使用ROC曲线构建和评估GBM预测模型,与BEST-J得分进行比较.
主要成果:
- 在178名患者中观察到16.29%的出血发生率.
- 出血的独立风险因素包括瘤大小≥3厘米,手术出血和C反应蛋白 (CRP) 的升高.
- 与BEST-J得分 (AUC=0.653) 相比,GBM模型的预测性能更好 (AUC=0.818).
结论:
- 瘤大小,手术出血和高CRP水平是ESD后出血的重要预测因素.
- 开发的GBM预测模型在预测ESD后手术后出血时提供了更高的准确性.
- 这种GBM模型可以帮助风险分层和管理患有食道癌ESD的患者.
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