{"title":"A nomogram of inflammatory indexes for preoperatively predicting the risk of lymph node metastasis in colorectal cancer.","authors":"Xuemei Wen, Haoran Sun, Shijiang Du, Junkai Xia, Wenjun Zhang, Fujie Zhang","doi":"10.1007/s10151-024-03010-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the independent risk factors associated with the development of lymph node metastasis (LNM) in patients with colorectal cancer (CRC), focusing on preoperative systemic inflammatory indicators, and to construct a corresponding risk predictive model.</p><p><strong>Materials and methods: </strong>The clinical data of 241 patients with CRC who underwent surgery after the first diagnosis between January 2012 and December 2017 at our hospital were reviewed. A best logistic regression model was constructed by Lasso regression for multivariate analysis, from which a Nomogram was derived. Using bootstrap to conduct internal validation. The model's predictive performance and clinical practicability were evaluated using the receiver operating characteristic curve (ROC) curve, calibration curve, and decision curve analysis (DCA). External validation was conducted using retrospective data from 170 patients who underwent surgery between January 2020 and May 2022 at another hospital.</p><p><strong>Results: </strong>Cross-validation indicated smoking history, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), fibrinogen-albumin ratio (FAR), and fecal occult blood (FOB) as variables with non-zero coefficients. These factors were included in the logistic regression, and multivariate analysis confirmed that smoking history, NLR, LMR, FAR, and FOB were independent risk factors (P < 0.05). The ROC and calibration curve of the original model and external validation indicated strong predictive power of the model. DCA suggested the model's favorable clinical utility.</p><p><strong>Conclusions: </strong>The model constructed in this study has robust predictive performance and clinical utility for the preoperative determination of CRC LMN, offering significant for clinical decision-making in patients with CRC.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"28 1","pages":"148"},"PeriodicalIF":2.7000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534845/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-024-03010-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To investigate the independent risk factors associated with the development of lymph node metastasis (LNM) in patients with colorectal cancer (CRC), focusing on preoperative systemic inflammatory indicators, and to construct a corresponding risk predictive model.
Materials and methods: The clinical data of 241 patients with CRC who underwent surgery after the first diagnosis between January 2012 and December 2017 at our hospital were reviewed. A best logistic regression model was constructed by Lasso regression for multivariate analysis, from which a Nomogram was derived. Using bootstrap to conduct internal validation. The model's predictive performance and clinical practicability were evaluated using the receiver operating characteristic curve (ROC) curve, calibration curve, and decision curve analysis (DCA). External validation was conducted using retrospective data from 170 patients who underwent surgery between January 2020 and May 2022 at another hospital.
Results: Cross-validation indicated smoking history, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), fibrinogen-albumin ratio (FAR), and fecal occult blood (FOB) as variables with non-zero coefficients. These factors were included in the logistic regression, and multivariate analysis confirmed that smoking history, NLR, LMR, FAR, and FOB were independent risk factors (P < 0.05). The ROC and calibration curve of the original model and external validation indicated strong predictive power of the model. DCA suggested the model's favorable clinical utility.
Conclusions: The model constructed in this study has robust predictive performance and clinical utility for the preoperative determination of CRC LMN, offering significant for clinical decision-making in patients with CRC.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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