1.武汉科技大学医学部,湖北 武汉 430065
2.中国人民解放军中部战区总医院普通外科,湖北 武汉 430070
程盛,硕士研究生在读,主要从事胃肠方面的研究,Email:cs20220970@163.com
张智勇,Email:ptwkzzy@163.com
收稿:2024-05-28,
纸质出版:2024-12-22
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程盛,龙渡,匡鹏等.三酰甘油葡萄糖指数与结直肠癌手术预后相关性的临床研究[J].腹部外科,2024,37(06):431-441.
Cheng Sheng,Long Du,Kuang Peng,et al.Relationship between TyG index and prognosis of colorectal cancer surgery[J].J Abdominal Surg,2024,37(06):431-441.
程盛,龙渡,匡鹏等.三酰甘油葡萄糖指数与结直肠癌手术预后相关性的临床研究[J].腹部外科,2024,37(06):431-441. DOI: 10.3969/j.issn.1003-5591.2024.06.007.
Cheng Sheng,Long Du,Kuang Peng,et al.Relationship between TyG index and prognosis of colorectal cancer surgery[J].J Abdominal Surg,2024,37(06):431-441. DOI: 10.3969/j.issn.1003-5591.2024.06.007.
目的
2
本研究旨在评估三酰甘油葡萄糖(triglycride-glucose,TyG) 指数与结直肠癌(colorectal cancer,CRC)病人手术预后的相关性。
方法
2
回顾性分析了中部战区总医院2012年1月至2015年12月接受根治性手术的CRC病人356例。应用R4.3.3统计软件完成列线图预测模型,通过计算一致性指数(C-指数)和绘制校准曲线评估列线图预测模型的区分度和准确性。另收集2016年1月至2018年12月行直肠癌根治术的137例病人资料作为外部验证数据。
结果
2
TyG指数、术前年龄、预后营养指数、肿瘤分期、肿瘤分化程度和术后并发症是独立预后因素(均
P
<0.05)。根据log-rank检验分析,高TyG组与低TyG指数组风险比为1.847(95%
CI
:1.205~2.831,
P
=0.0109),训练队列中列线图模型的C-指数为0.742(95%
CI
:0.689~0.795)内部验证显示,校准曲线表明列线图预测生存率与实际生存率具有良好的一致性。外部验证采用时段验证,验证队列中列线图C-指数为0.769(95%
CI
:0.6
73~0.865),校准曲线表明列线图预测生存率与实际生存率具有良好的一致性。
结论
2
TyG指数是CRC病人手术预后的独立危险因素,TyG指数越高,接受结直肠癌手术病人的预后越差。
Objective
2
To evaluate the correlation between triglyceride glucose (TyG)index and postoperative prognosis in colorectal cancer (CRC) patients.
Methods
2
From January 2012 to December 2015, 376 CRC patients undergoing radical resection were retrospectively reviewed. R Project for Statistical Computing (Version 4.3.3) was utilized for constructing a nomogram prediction model and its differentiation and accuracy were evaluated by calculating consistency index (C-index) and plotting calibration curves. From January 2016 to December 2018, the clinical data of 137 patients undergoing radical resection for rectal cancer were collected for external validation.
Results
2
TyG index, preoperative age, prognostic nutritional index (PNI) score, tumor stage, differentiation degree and postoperative complications were independent prognostic factors (all
P
<
0.05). According to the results of log-rank test, risk ratio between high TYG and low TyG index groups was 1.847 (95%CI: 1.205-2.831,
P
=0.010 9) and C-index of nomogram model was 0.742 in training cohort. Calibration curve indicated that survival rate as predicted by nomogram accorded well with actual survival rate. External verification was conducted by time period verification. C-index of column-line was 0.769 in verification cohort. Calibration curve indicated that column-line predicted survival rate accorded well with actual survival rate.
Conclusion
2
TyG index is an independent risk factor for the postoperative prognosis of CRC patients. The higher the TyG index, the worse the postoperative prognosis of patients.
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