各位作者、审稿专家:
本刊官方微信服务号新增稿件状态查询服务,无需反复登录投稿系统,微信即可随时查看审稿进度、修回通知、录用结果,稿件更新实时推送提醒,同步接收期刊征稿、学术资讯。
微信搜索关注广州医药杂志服务号 → 点击菜单栏「绑定账号」→ 输入投稿邮箱完成账号关联;请关闭微信消息免打扰,避免遗漏稿件通知。
《广州医药》编辑部
目的 评估使用炎症、免疫及营养指标对于胃癌根治术后发生腹膜转移的预测作用,并建立适用于术前风险评估的预测模型。方法 回顾性收集2022—2024年苏州市立医院85例晚期胃癌患者的临床资料,按术后是否发生腹膜转移分为转移组44例与非转移组41例。通过分析比较两组间的营养参数[血清白蛋白、纤维蛋白原及预后营养指数(PNI)]、炎症指标[中性粒细胞计数、C反应蛋白、中性粒细胞与淋巴细胞比值(NLR)及全身免疫炎症指数(SII)]、肿瘤标志物以及免疫功能指标(淋巴细胞计数、IL-2、IL-6、TNF-α和IFN-γ)等。使用单因素及多因素Logistic回归分析确定独立预测因子,并构建预测模型,采用Bootstrap法内部验证,计算校正后的曲线下面积及收缩因子,以优化模型性能。结果 多因素分析结果显示,IL-6(OR=1.116,95%CI:1.020~1.224)与CA125(OR=1.016,95%CI:1.006~1.026)为术后腹膜转移的独立预测因素,构建的预测模型区分能力良好,初始AUC为0.801(95%CI:0.702~0.900),经Bootstrap校正后AUC为0.797,模型校准度理想,具有良好的临床稳健性。结论 基于术前IL-6和CA125水平的预测模型,可用于评估胃癌患者根治术后发生腹膜转移的风险。该模型可在术前阶段有效识别高风险病例,为临床制定个体化辅助治疗方案及随访策略提供关键参考,并具有改善患者预后的潜在价值。
Objective To evaluate the predictive value of inflammatory,immune,and nutritional indicators for peritoneal metastasis after radical gastrectomy in gastric cancer and to establish a predictive model applicable for preoperative risk assessment.Methods Clinical data from 85 patients with advanced gastric cancer treated at Suzhou Municipal Hospital between 2022 and 2024 were retrospectively collected.Patients were divided into two groups based on postoperative peritoneal metastasis occurrence:a metastasis group(n=44)and a non-metastasis group(n=41).Indicators analyzed and compared between groups included nutritional parameters(serum albumin,fibrinogen,PNI),inflammatory markers(neutrophil count,CRP,NLR,SII),tumor markers and immune indicators(lymphocyte count,IL-2,IL-6,TNF-α,IFN-γ).Univariate and multivariate logistic regression analyses identified independent predictors for constructing the prediction model.Internal validation was performed using 1 000 bootstrap resamples to calculate the adjusted area under the curve(AUC)and shrinkage factor for model optimization.Results Multivariate analysis identified IL-6(OR=1.116,95%CI:1.020-1.224)and CA125(OR=1.016,95%CI:1.006-1.026) as independent predictors of postoperative peritoneal metastasis.The constructed predictive model demonstrated good discriminatory ability,with an initial AUC of 0.801(95%CI:0.702–0.900)and a bootstrap-corrected AUC of 0.797.The model exhibited ideal calibration and good clinical robustness.Conclusions This study established a predictive model based on preoperative IL-6 and CA125 levels to assess the risk of peritoneal metastasis after radical surgery in gastric cancer patients.The model effectively identifies high-risk cases preoperatively,providing critical guidance for developing individualized adjuvant treatment and follow-up strategies,with potential to improve patient prognosis.