摘要
目的构建结肠息肉漏诊影响因素列线图预测模型,并评估其效能。方法选取2022年1月-2024年1月在安徽中科庚玖医院消化内科接受两次结肠镜检查的150例患者为研究对象。对比两次结肠镜的检查结果,将第二次检查发现新的结肠息肉认为发生漏诊,根据漏诊情况将患者分为漏诊组和未漏诊组。对比两组患者一般资料,分析结肠息肉漏诊的影响因素,并构建列线图模型。结果150例接受两次结肠镜检查的患者中,总漏诊例数32例,漏诊率为21.33%。与未漏诊组比较,漏诊组年龄更大,肠道清洁度更差,结肠息肉家族史、左半结肠、无蒂息肉占比更高,息肉直径更大,基础息肉数更多,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,肠道清洁度、结肠息肉家族史、息肉直径、息肉部位、息肉形态、基础息肉数是结肠息肉漏诊的影响因素(P<0.05)。采用受试者工作曲线(ROC)评估列线图模型的区分度,结果显示,曲线下面积、灵敏度及特异度分别为0.834、81.58%、82.76%。Bootstrap法内部验证结果显示,本研究所构建的列线图模型的C-index指数为0.882(95%CI:0.807~0.949)。结论结肠息肉存在一定漏诊情况,肠道清洁度、结肠息肉家族史、息肉直径、息肉部位、息肉形态、基础息肉数是结肠息肉漏诊的影响因素,以此构建的列线图模型具有较好的预测效能。
Objective To construct a prediction model of factors influencing colon polyp missed diagnosis and evaluate its effectiveness.Methods About 150 patients who underwent 2 colonoscopies in the hospital from January 2022 to January 2024 were selected for the study.To compare the results of the 2 colonoscopies,new colon polyps found in the second examination were considered to have occurred as a missed diagnosis,and the patients were divided into a missed group and an non-missed group according to the missed diagnosis.The general data of the 2 groups were compared to analyze the factors affecting the missed diagnosis of colon polyp,and the nomogram model was constructed.Results In 150 patients who underwent 2 colonoscopies,the total number of cases of missed diagnosis was 32,and the rate of missed diagnosis was 21.33%.Compared with the non-missed group,the missed group had a significantly older age,poorer bowel cleanliness,higher proportion of family history of colorectal polyps,left-sided colon location,sessile polyps,larger polyp diameter and greater baseline number of polyps,with statistically significant differences(P<0.05).Analysis of multifactorial Logistic regression showed that intestinal cleanliness,family history of colon polyps,polyp diameter,polyp site,polyp morphology and number of underlying polyps were the influencing factors of colonic polyp leakage(P<0.05).The results of evaluating the discriminative power of the nomograms model using the subject's working curve(ROC)showed that the area under the curve,sensitivity and specificity were 0.834,81.58%and 82.76%,respectively.The results of internal validation of the Bootstrap method showed that the C-index index of the nomograms model constructed in this study was 0.882(95%CI:0.807~0.949).Conclusion There is a certain degree of leakage of colon polyps,and bowel cleanliness,family history of colon polyps,polyp diameter,polyp site,polyp morphology and number of underlying polyps are the factors influencing the leakage of colon polyps,and the nomograms model constructed in this way has a better predictive efficacy.
作者
杨莉
张家强
岳萍萍
薛琰
黄畅
YANG Li;ZHANG Jiaqiang;YUE Pingping;XUE Yan;HUANG Chang(Department of Gastroenterology,Anhui Zhongke Gengjiu Hospital,Hefei 230041,China)
出处
《新疆医科大学学报》
2025年第2期210-214,228,共6页
Journal of Xinjiang Medical University
基金
安徽省卫生健康委员会科研课题项目(2020-072)。
关键词
结肠息肉
漏诊
影响因素
列线图
colon polyp
missed diagnosis
influencing factors
nomograms model
