Development of a predictive model for colorectal polyp recurrence risk based on polyp characteristics and serum indicators

doi:10.11958/20252207

Abstract

Abstract:

Objective To develop a recurrence risk prediction model for colorectal polyps based on polyp characteristics and serological indicators, aiming to improve early recognition of colorectal polyp recurrence and personalized treatment. Methods A retrospective analysis was conducted on clinical data from 235 patients who underwent colorectal polyp resection. Based on whether recurrence occurred, the patients were divided into the recurrence group (56 cases) and the non-recurrence group (179 cases). Clinical data, polyp characteristics and related serological indicators were collected. Logistic regression analysis was used to identify independent predictors for colorectal polyp recurrence. Based on the results of Logistic regression, a nomogram model for predicting colorectal polyp recurrence risk was constructed, and the model’s predictive performance was evaluated using ROC and calibration curves. Results Compared with the non-recurrence group, the recurrence group had higher age, male proportion, body mass index (BMI), family history proportion, polyp size, proportion of adenomatous polyps, proportion of high-grade lesions, and elevated serum levels of carcinoembryonic antigen (CEA) and C-reactive protein (CRP) (P < 0.05). Logistic regression analysis showed that age (OR = 1.032, 95%CI: 1.003-1.062), BMI (OR = 1.064, 95%CI: 1.000-1.131), family history (OR = 2.34, 95%CI: 1.039-5.267), high-grade pathological lesions (OR = 6.323, 95%CI: 2.184-18.430), polyp size (OR = 3.161, 95%CI: 1.434-6.965), CEA (OR = 1.486, 95%CI: 1.160-1.904), and CRP (OR = 1.132, 95%CI: 1.022-1.254) were important predictors for colorectal polyp recurrence. Based on these factors, a nomogram model for predicting colorectal polyp recurrence risk was constructed. Model evaluation showed that the nomogram had an area under the curve (AUC) of 0.893 (95%CI: 0.836-0.950), sensitivity of 81.6%, specificity of 87.5%, and good discrimination and calibration (Hosmer-Lemeshow χ² = 2.396, P = 0.743). Conclusion The recurrence risk prediction model based on polyp characteristics and serological indicators developed in this study has high predictive efficacy and can effectively assess the risk of colorectal polyp recurrence.

Key words: intestinal polyposis, recurrence, nomograms, polyp characteristics, serological indicators

CLC Number:

R574.62，R574.63

Figures/Tables 5

References 24

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组别	n		年龄/岁	男性		BMI/（kg/m²）		吸烟史		饮酒史	有家族史		息肉数量/个	息肉大小/cm	病理高级别	伴有不典型增生
无复发组	179		57.5±12.8	98（54.2）		23.0±3.3		53（29.6）		58（32.4）	18（10.1）		2（2，3）	1.0±0.5	35（19.6）	38（21.2）
复发组	56		62.3±11.3	41（73.2）		25.2±3.5		16（28.6）		18（32.1）	12（21.4）		2（2，3）	1.4±0.6	21（38.0）	18（32.1）
t或χ²			2.516^＊	6.019^＊		4.291^＊＊		0.022		0.001	4.954^＊		1.865	4.973^＊＊	7.569^＊＊	2.799
组别		息肉位置					CEA/（μg/L）		CRP/（mg/L）			血清铁蛋白/（μg/L）			CA19-9/（U/mL）
组别		结肠			直肠		CEA/（μg/L）		CRP/（mg/L）			血清铁蛋白/（μg/L）			CA19-9/（U/mL）
无复发组		118（65.9）			61（34.1）		2.8±1.1		7.8±3.0			115.3±41.2			18.4±7.2
复发组		36（64.3）			20（35.7）		4.2±2.0		9.5±4.2			120.5±38.6			20.1±8.5
χ²或t		0.051					6.689^＊＊		3.342^＊＊			0.836			1.475

组别	n		年龄/岁	男性		BMI/（kg/m²）		吸烟史		饮酒史	有家族史		息肉数量/个	息肉大小/cm	病理高级别	伴有不典型增生
无复发组	179		57.5±12.8	98（54.2）		23.0±3.3		53（29.6）		58（32.4）	18（10.1）		2（2，3）	1.0±0.5	35（19.6）	38（21.2）
复发组	56		62.3±11.3	41（73.2）		25.2±3.5		16（28.6）		18（32.1）	12（21.4）		2（2，3）	1.4±0.6	21（38.0）	18（32.1）
t或χ²			2.516^＊	6.019^＊		4.291^＊＊		0.022		0.001	4.954^＊		1.865	4.973^＊＊	7.569^＊＊	2.799
组别		息肉位置					CEA/（μg/L）		CRP/（mg/L）			血清铁蛋白/（μg/L）			CA19-9/（U/mL）
组别		结肠			直肠		CEA/（μg/L）		CRP/（mg/L）			血清铁蛋白/（μg/L）			CA19-9/（U/mL）
无复发组		118（65.9）			61（34.1）		2.8±1.1		7.8±3.0			115.3±41.2			18.4±7.2
复发组		36（64.3）			20（35.7）		4.2±2.0		9.5±4.2			120.5±38.6			20.1±8.5
χ²或t		0.051					6.689^＊＊		3.342^＊＊			0.836			1.475

变量	β	SE	Wald χ²	P	OR	OR 95%CI
年龄	0.032	0.015	4.288	0.038	1.032	1.003~1.062
性别	0.548	0.297	3.421	0.064	1.732	0.967~3.104
BMI	0.062	0.032	3.881	0.049	1.064	1.000~1.131
吸烟史	0.517	0.306	2.871	0.090	1.677	0.914~3.080
饮酒史	0.245	0.296	0.690	0.406	1.278	0.711~2.302
家族史	0.851	0.415	4.338	0.037	2.340	1.039~5.267
病理学分级	1.845	0.579	10.281	0.001	6.323	2.184~18.430
息肉大小	1.151	0.371	9.645	0.002	3.161	1.434~6.965
CEA	0.396	0.123	9.982	0.002	1.486	1.160~1.904
CRP	0.124	0.052	5.733	0.017	1.132	1.022~1.254
常数项	0.839	0.438	3.669	0.055	2.314

变量	β	SE	Wald χ²	P	OR	OR 95%CI
年龄	0.032	0.015	4.288	0.038	1.032	1.003~1.062
性别	0.548	0.297	3.421	0.064	1.732	0.967~3.104
BMI	0.062	0.032	3.881	0.049	1.064	1.000~1.131
吸烟史	0.517	0.306	2.871	0.090	1.677	0.914~3.080
饮酒史	0.245	0.296	0.690	0.406	1.278	0.711~2.302
家族史	0.851	0.415	4.338	0.037	2.340	1.039~5.267
病理学分级	1.845	0.579	10.281	0.001	6.323	2.184~18.430
息肉大小	1.151	0.371	9.645	0.002	3.161	1.434~6.965
CEA	0.396	0.123	9.982	0.002	1.486	1.160~1.904
CRP	0.124	0.052	5.733	0.017	1.132	1.022~1.254
常数项	0.839	0.438	3.669	0.055	2.314