| Citation: |
SHI Xiaoqing, LYU Qunli, XIAO Peihua, WU Jianzhong, HONG Pei. Application value of constructing a prediction model based on nutritional status combined with clinical data for infectious complications after radical gastrectomy for gastric cancer[J]. Journal of Clinical Medicine in Practice, 2025, 29(2): 63-68, 74. DOI: 10.7619/jcmp.20243772
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To explore the application value of predictive model based on nutritional status combined with clinical data in infectious complications after radical gastrectomy for gastric cancer.
The clinical data on 394 gastric cancer patients who underwent radical gastrectomy at Suzhou Ninth Hospital Affiliated to Soochow University from January 2017 to July 2024 were retrospectively collected. According to whether the patients developed infection after surgery, they were divided into infection group (n=73) and non-infection group (n=321) based on whether they developed postoperative infections or not. The least absolute shrinkage and selection operator (LASSO) method was used to obtain the optimal related features associated with infectious complications after radical gastrectomy for gastric cancer. Multivariate Logistic regression analysis was conducted to screen for risk factors of infectious complications after radical gastrectomy. R software was used to randomly select 70% of data as training set (for establishing the nomogram model) and 30% of data as test set. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, Bootstrap sampling validation, and decision curve analysis (DCA) were used to assess the value of the predictive model.
of the 394 gastric cancer patients, 73 developed postoperative infectious complications, including 53.42% with lung infections, 17.81% with intra-abdominal infections, 16.44% with urinary tract infections, and 12.33% with wound infections. Age, diabetes mellitus, preoperative nutritional risk, high preoperative PIV, combined organ resection, and prolonged operation time were identified as risk factors for infectious complications after radical gastrectomy (P < 0.05). In the training set, the AUC of the nomogram model was 0.898, and the AUC validated in the test set was 0.891. Bootstrap sampling validation with 1, 000 iterations showed that the average errors between the predicted probabilities and actual values in the training and test sets were 0.019 and 0.024, respectively. DCA results indicated that the model had clinical utility.
Infectious complications after gastrectomy for gastric cancer are common, and the predictive model based on nutritional assessment combined with clinical data has high value in predicting the risk of infectious complications after gastrectomy.
| [1] |
BRAY F, LAVERSANNE M, SUNG H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263. doi: 10.3322/caac.21834
|
| [2] |
中国胃肠肿瘤外科联盟, 中国抗癌协会胃癌专业委员会. 中国胃肠肿瘤外科术后并发症诊断登记规范专家共识(2018版)[J]. 中国实用外科杂志, 2018, 38(6): 589-595.
|
| [3] |
XIA X, ZHANG Z Z, ZHU C C, et al. Neutrophil extracellular traps promote metastasis in gastric cancer patients with postoperative abdominal infectious complications[J]. Nat Commun, 2022, 13(1): 1017. doi: 10.1038/s41467-022-28492-5
|
| [4] |
HERSBERGER L, BARGETZI L, BARGETZI A, et al. Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: secondary analysis of a prospective randomised trial[J]. Clin Nutr, 2020, 39(9): 2720-2729. doi: 10.1016/j.clnu.2019.11.041
|
| [5] |
中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志, 2018, 41(4): 255-280.
|
| [6] |
中华医学会外科学分会外科感染与重症医学学组, 中国医师协会外科医师分会肠瘘外科医师专业委员会. 中国腹腔感染诊治指南(2019版)[J]. 中国实用外科杂志, 2020, 40(1): 1-16.
|
| [7] |
尿路感染诊断与治疗中国专家共识编写组. 尿路感染诊断与治疗中国专家共识(2015版): 尿路感染抗菌药物选择策略及特殊类型尿路感染的治疗建议[J]. 中华泌尿外科杂志, 2015, 36(4): 245-248.
|
| [8] |
王荣土, 吾红光, 吴智强, 等. 胃癌患者手术部位感染调查分析[J]. 中华医院感染学杂志, 2015, 25(3): 632-634.
|
| [9] |
罗进, 燕速, 邢多, 等. 胃癌根治术术后手术部位感染的危险因素分析及预测模型的建立[J]. 中国消毒学杂志, 2022, 39(1): 47-49.
|
| [10] |
LIU X, XUE Z G, YU J C, et al. Risk factors for postoperative infectious complications in elderly patients with gastric cancer[J]. Cancer Manag Res, 2020, 12: 4391-4398.
|
| [11] |
于宗平, 高鹏, 彭新刚, 等. C反应蛋白、白细胞计数和T淋巴亚群与胃癌患者术后感染性并发症的关系及其诊断价值分析[J]. 现代生物医学进展, 2020, 20(20): 3923-3928.
|
| [12] |
刘瞻, 赵英丽, 陈晓婷. 维生素D水平与2型糖尿病并发肺部感染患者免疫功能及其预后的关系[J]. 中华医院感染学杂志, 2022, 32(9): 1295-1298.
|
| [13] |
DONG Z, LIU G, TU L Q, et al. Establishment of a prediction model of postoperative infection complications in patients with gastric cancer and its impact on prognosis[J]. J Gastrointest Oncol, 2023, 14(3): 1250-1258.
|
| [14] |
GUVEN D C, SAHIN T K, ERUL E, et al. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis[J]. Cancers, 2022, 14(11): 2675.
|
| [15] |
倪子龙, 朱正秋, 周双, 等. 泛免疫炎症值与结直肠癌患者术后感染性并发症及预后的关系[J]. 现代肿瘤医学, 2024, 32(1): 87-92.
|
| [16] |
金俊蕊, 邓靖宇, 梁寒, 等. 胃癌根治术围手术期并发症危险因素分析及其对预后的影响[J]. 中华胃肠外科杂志, 2018, 21(1): 53-60.
|
| [17] |
HE L J, JIANG Z H, WANG W P, et al. Predictors for different types of surgical site infection in patients with gastric cancer: a systematic review and meta-analysis[J]. Int Wound J, 2024, 21(4): e14549.
|
| [18] |
钟鑫, 朱薇, 魏猛, 等. 胃癌根治术后肺部并发症相关危险因素分析及预测模型构建[J]. 腹腔镜外科杂志, 2021, 26(12): 898-904.
|
| [19] |
JAHANGIR F, HAGHDOOST A, MOAMERI H, et al. Incidence and risk factors of surgical site infection in abdominal surgeries: a scoping review of cohort and case-control studies[J]. Iran J Med Sci, 2024, 49(7): 402-412.
|
| [20] |
把明勤, 陈柳, 朱小琼, 等. NRS2002和PNI营养筛查方法在胃癌患者预后中的预测价值[J]. 中华全科医学, 2023, 21(7): 1121-1124, 1247.
|
| [21] |
周晓梅, 陈赛华, 王鼎, 等. 营养支持链式管理在胃癌围术期患者中的应用[J]. 实用临床医药杂志, 2024, 28(12): 61-65.
|
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