<sup>125</sup>I粒子支架置入治疗食管癌术后出血风险因素预测模型建立与验证-东南大学学报医学版

¹²⁵I粒子支架置入治疗食管癌术后出血风险因素预测模型建立与验证

作者：秦娟¹ 朱海东¹ 陆建¹ 郭金和¹ 倪才方² 吴萍³ 徐浩⁴ 茅爱武⁵ 滕皋军¹

单位：1. 东南大学附属中大医院介入与血管外科, 江苏南京 210009;
2. 苏州大学第一附属医院介入放射科, 江苏苏州 215006;
3. 徐州中心医院/东南大学附属徐州医院消化科, 江苏徐州 221009;
4. 徐州医科大学附属医院介入放射科, 江苏徐州 221006;
5. 上海交通大

关键词：食管癌支架近距离治疗出血危险因素预测

分类号：R735.1

出版年·卷·期（页码）：2019·38·第一期（159-164）

摘要：

目的：探讨¹²⁵I粒子支架置入术治疗晚期食管鳞状细胞癌患者发生出血的危险因素。方法：对2012年6月至2016年3月在中国5家医院接受¹²⁵I粒子支架置入术的晚期食管鳞癌患者进行回顾性研究。单因素和多因素分析确定支架置入术后出血的独立危险因素。采用Logistic回归系数对模型进行验证，ROC曲线对模型效果进行评价。结果：157例患者纳入本研究，21例（13.4%）患者支架置入后发生出血。单因素和多因素回归模型分析显示既往放化疗史（P=0.020）和肿瘤部位（P=0.045）是出血独立危险因素。内部验证ROC值为0.686（95%CI：0.569~0.802，P<0.05）。结论：肿瘤部位和术前放化疗史是¹²⁵I粒子支架置入术后出血发生的独立危险因素。临床应用该姑息性治疗方法时应考虑这些因素，以预防严重并发症的发生。

Objective:To explore the risk factors of haemorrhage in patients with advanced esophageal squamous cell carcinoma after ¹²⁵I-seed-loaded stent placement. Methods:Patients with advanced esophageal squamous cell carcinoma who underwent ¹²⁵I seed-loaded stent placement from five hospitals in China, between June 2012 and March 2016,were retrospectively analyzed.Univariate and multivariate analyses were used to develope a model to identify the independent risk factors for haemorrhage after stent placement. The logistic regression coefficient was used to verify the model. Finally, ROC curve was used to evaluate the effect of the model by comparing the simulation results with the real results. Results:The median age of 157 patients was 69.6 years(IQR:61.5-78.5). Haemorrhage was observed in 21(13.4%)patients. Univariate analyses showed that priorchemoradiotherapy, albumenand tumour location were significantly associated with the post-procedure haemorrhage. However, the multivariate analyses showed that priorchemoradiotherapy(P=0.020)and tumour location(P=0.045)were independent risk factors of the haemorrhage. The ROC value of internal validation for this model was 0.686(95%CI:0.569-0.802, P<0.05). Conclusion:Tumor site and preoperative history of radiotherapy and chemotherapy were independent risk factors for bleeding after ¹²⁵I seed stent implantation. These factors should be taken into account in clinical application of palliative therapy to prevent serious complications.

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