结直肠癌伴同时性肝转移的特征性术前临床指标及预测模型.pdfVIP

zy@cjocm.cn 中医临床研究 010 CJCM 中医临床研究 2013 年第 5 卷 第 11 期 -1- 结直肠癌伴同时性肝转移的特征性术前临床指标及 预测模型 Characteristic preoperative clinical indexes and prediction model for colorectal cancer with synchronous liver metastasis 刘方奇 1 文静然 2 张晓艳 2 徐 烨 1 （1.复旦大学附属肿瘤医院，上海，200032；2. 同济大学生命科学与技术学院，上海，200092 ） 中图分类号：R735.3 ＋3 文献标识码：A 文章编号：1674-7860 （2013 ）11-0001-05 证型：IAD 【摘 要】 目的：探讨结直肠癌伴同时性肝转移的特征性临床术前指标，并期基于此些指标建立预测模型。方法：1052 例 结直肠癌患者中以伴或不伴同时性肝转移为分组，使用信息熵增益方法筛选出特征性术前临床指标，并且使用 Logistic 回归方法 建立预测模型；在 150 例患者（独立样本）中进行模型测试。结果：筛选出 CEA，CA50 ，CA199 ，肿瘤部位（结肠/直肠），原发 肿瘤最大径为特征性术前临床指标。以术前血清 CEA 及 CA50 值建立模型，敏感性 0.82 ，特异性 0.7342 ，准确率 0.7423 ，ROC 曲线下面积 AUC 为 0.838 ；模型测试表现：ROC 曲线下面积 AUC 为 0.9046。结论：CEA，CA50 ，CA199 ，肿瘤部位（直肠/结 肠），原发肿瘤肿瘤最大径等术前临床指标与结直肠癌伴同时性肝转移有关，以术前血清 CEA 及 CA50 值建立 Logistic 回归模型 对其诊断有一定的帮助。 【关键词】结直肠癌伴同时性肝转移；特征性术前临床指标；预测模型；CEA；CA50 【Abstract 】Objective: To discuss characteristic preoperative clinical indexes for colorectal cancer with synchronous liver metastasis and establish prediction model based on these indexes. Methods: 1052 colorectal cancer patients were divided into two groups, with or without synchronous liver metastasis. Information entropy method was used to gain preoperative clinical characteristic indexes and Logistic regression method was used to establish prediction model. The model was tested in an independent sample of 150 colorectal cancer patients. Results: CEA, CA50, CA199, tumor location (colon/rectum) and maximum diameter of primary tumor were selected as the characteristic preoperative clinical indexes. Preoperative serum CEA and CA50 were used to set up prediction model with a sensitivity of 0.82, specificity of 0.7342 and accuracy of 0.7423, the AUC was 0.838. Model test performance showed