Design and verification of screening model of metachronous advanced adenoma for postoperative colorectal cancer patients

doi:10.3969/j.issn.1006-7795.2023.02.017

Abstract

Abstract: Objective To analysis the potential risk factors for metachronous advanced adenoma (MAA) in postoperative colorectal cancer (CRC) patients, so as to develop an individual surveillance scheme and verify it. Methods Totally 734 CRC patients who underwent surgery from April 2007 to October 2017 were divided into derivation group and validation group, and underwent surveillance colonoscopy for 3 years. Univariate and multivariate logistic analysis were conducted to establish screening model, and verify it in validation group. Results Totally 734 patients (male/female: 440/294) were finally included. The average age was (64.6 ±11.5) years, and the overall MAA incidence was 11.9% (12.0％ in derivation group and 11.6％ in validation group). Male, diabetes mellitus, right-sided colon cancer, moderately and poorly differentiated adenocarcinoma, synchronous adenoma, synchronous advanced adenoma were independent risk factors for MAA. According to the results of multivariate logistic analysis, MAA screening model and nomogram were established. The area under the curve (AUC) of MAA screening model was 0.957(95% CI: 0.935－0.973), and critical value was 0.938 7. External validation showed that the sensitivity was 93.1%, specificity was 89.1%, and the consistency between screening results and actual results was high (Kappa=0.62). Conclusions The screening model of metachronous advanced adenoma for postoperative CRC patients was constructed based on seven factors: male, diabetes history, right-sided colon cancer, moderately and poorly differentiated adenocarcinoma, synchronous adenoma, and synchronous advanced adenoma. It had high authenticity and consistency with actual results, and showed clinical application value.

Key words: colorectal cancer, metachronous advanced adenoma, screening model, verification

CLC Number:

R735

Guo Chunmei, Liu Hong, Jiao Yue, Zhang Qian, Wang Canghai, Wang Yadan, Lin Wu, Wei Nan, Zhang Shutian, Wu Jing. Design and verification of screening model of metachronous advanced adenoma for postoperative colorectal cancer patients[J]. Journal of Capital Medical University, 2023, 44(2): 295-301.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.02.017

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I2/295

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