Page 67 - 南京医科大学自然版

第44卷第5期 南京医科大学学报（自然科学版）
2024年5月 Journal of Nanjing Medical University（Natural Sciences） ·655 ·

·临床研究·

肝细胞肝癌患者首次经动脉化疗栓塞术后中重度腹痛预测模

型的构建及验证

包建英 ，崔传芳 ，林 征 ，周卫忠 ，周春高 ，刘 圣 ，施海彬 1
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南京医科大学第一附属医院介入放射科，护理部，江苏 南京 210029
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［摘 要］ 目的：分析肝细胞肝癌（hepatocellular carcinoma，HCC）患者首次经动脉化疗栓塞术（transarterial chemoembolization，
TACE）治疗后发生中重度腹痛的危险因素，并构建预测模型。方法：选取2021年1月—2023年6月首次接受TACE治疗的219例
HCC患者。依据接受TACE治疗的时间先后顺序，按照7∶3将患者分为训练集（154例）和验证集（65例）。依据TACE术后是否
发生中重度腹痛将训练集患者分为中重度腹痛组和无中重度腹痛组，比较两组的人口学及临床特征。采用Logistic回归分析

HCC患者首次TACE治疗后发生中重度腹痛的危险因素，并构建预测模型。采用受试者工作特性（receiver operator characteris⁃
tic，ROC）曲线法评估模型在训练集和验证集中对 TACE 术后出现中重度腹痛的预测效能。结果：训练集 154 例中，42 例
（27.3%）HCC 患者 TACE 术后出现中重度腹痛。Logistic 回归显示，肿瘤距肝包膜距离≤1 cm（P=0.001）、碘油使用量>10 mL
（P < 0.001）和使用无水酒精栓塞（P=0.007）是HCC患者首次TACE术后发生中重度腹痛的独立危险因素。预警模型为2.199×
肿瘤距肝包膜距离+2.252×碘油使用量+1.637×使用无水酒精-3.829。模型在训练集和验证集中预测中重度腹痛的ROC曲线
下面积分别为0.895和0.853。结论：肿瘤距肝包膜距离≤1 cm、碘油使用量>10 mL和使用无水酒精栓塞是HCC患者首次TACE
术后发生中重度腹痛的危险因素。预测模型可为HCC患者首次TACE术后中重度腹痛管理提供依据。
［关键词］ 肝细胞肝癌；经动脉化疗栓塞术；中重度腹痛；预测模型
［中图分类号］ R735.7 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）05⁃655⁃06
doi：10.7655/NYDXBNSN231126

Development and validation of predictive model for moderate to severe abdominal pain
after first⁃time transarterial chemoembolization in patients with hepatocellularcarcinoma

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BAO Jianying ，CUI Chuanfang ，LIN Zheng ，ZHOU Weizhong ，ZHOU Chungao ，LIU Sheng ，SHI Haibin 1
1 Department of Intervention Radiology，Nursing，the First Affiliated Hospital of Nanjing Medical University，Nanjing
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210029，China
［Abstract］ Objective：To analyze the risk factors for moderate to severe abdominal pain in patients with hepatocellular carcinoma
（HCC）after their first transarterial chemoembolization（TACE）and to establish a predictive model. Methods：A total of 219 HCC
patients who underwent first ⁃ time TACE in our hospital between January 2021 and June 2023 were collected. Based on the
chronological order of receiving TACE treatment，the patients were divided into a training set（154 cases）and a validation set（65
cases）in a 7∶3 ratio. The training set patients were further categorized into the moderate to severe abdominal pain group and the non⁃
moderate to severe abdominal pain group based on whether moderate to severe abdominal pain occurred after TACE，and demographic
and clinical characteristics were compared between the two groups. Logistic regression analysis was used to analyze the risk factors for
moderate to severe abdominal pain after the first TACE treatment in HCC patients and to construct a predictive model. The receiver
operator characteristic（ROC）curve method was used to evaluate the predictive performance of the model in the training and validation
sets for the occurrence of moderate to severe abdominal pain after TACE. Results：In the training set of 154 cases，42 cases（27.3%）of
HCC patients experienced moderate to severe abdominal pain after TACE. Logistic regression revealed that tumor distance from the
liver capsule ≤1 cm（P=0.001），iodized oil usage >10 mL（P < 0.001），and the use of non⁃alcoholic ethanol embolization（P=0.007）

［基金项目］ 江苏省科教能力提升工程（JSDW202243）；江苏省人民医院临床能力提升工程（JSPH⁃NC⁃2022⁃1）
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通信作者（Corresponding author），E⁃mail：linzheng20232023@163.com