本文已被:浏览 139次 下载 41次
Received:July 09, 2024 Published Online:May 20, 2025
Received:July 09, 2024 Published Online:May 20, 2025
中文摘要: 目的 探讨 logistic回归、支持向量机(SVM)模型在宫颈癌术后 14 d内盆腔淋巴囊肿形成中的预测价值及效果对比。方法 回顾性分析 2020年 1月至 2024年 1月在北部战区总医院接受手术治疗的 128例宫颈癌患者的临床资料,将其按照 7∶3划分为训练集(n=90)和测试集(n=38)。在训练集中采用单因素、多因素 logistic回归分析宫颈癌术后 14 d内盆腔淋巴囊肿形成的危险因素,运用 logistic回归变量筛选策略,分别构建 logistic回归和 SVM模型,并绘制两种模型在训练集和测试集中的受试者工作特征(ROC)曲线,比较其预测效果。结果 训练集宫颈癌患者术后 14 d内盆腔淋巴囊肿形成的发生率为 38.89%(35/90),验证集的发生率为 42.11%(16/38)。多因素 logistic回归分析结果显示,采用经腹开放性手术、手术器械采用单极电刀、淋巴结清除数目> 20个、淋巴结清除范围为盆腔 +腹主动脉旁、引流天数> 3d、术后放化疗是宫颈癌术后 14 d内盆腔淋巴囊肿形成的危险因素(P<0.05);其预测变量重要性由大到小排序为淋巴结清除范围、术后放化疗、淋巴结清除数目、引流天数、采用单极电刀、采用经腹开放性手术; SVM模型为采用经腹开放性手术、采用单极电刀、淋巴结清除数目、淋巴结清除范围、引流天数、术后放化疗。 SVM模型在训练集和测试集预测宫颈癌术后盆腔淋巴囊肿形成的准确度(88.22%、78.95%)、AUC(0.785、0.776)较 logistic回归模型的准确度(75.56%、71.05%)、AUC(0.712、0.694)高,且两种模型的AUC(0.785、0.776)比较差异有统计学意义(训练集: Z=8.655,P=0.001;测试集: Z=2.454,P=0.003)。结论 SVM模型预测宫颈癌患者术后 14 d内盆腔淋巴囊肿形成的准确度、灵敏度、特异度、AUC等指标均优于 logistic回归模型,预测效果佳。
Abstract:Objective To explore the predictive walue and effect of logistic regression and support vector machine (SVM) model in the formation of pelvic lymphocysts uithin 14 days after cervical cancer surgery. Methods A retrospective analysis was conducted on the clinical data of 128 cervical cancer patients who underwent surgicaltreatment at Northern Theater Command General Hospital from January 2020 to January 2024. The data were divided into a training set (n=90) and a test set (n=38) in a 7∶3 ratio. In the training set, univariate and multivariate logistic regression were used to analyze the risk factors for the formation of pelvic lymphocysts within 14 days after cervicalcancer surgery. Logistic regression and SVM model were constructed by using the logistic regression variable screeningstrategy. Receiver operating characteristic (ROC) curves were drawn for both models in the training and test sets to compare their predictive performance. Results The incidence of pelvic lymphocysts in cervical cancer patients 14 days after surgery was 38.89% (35/90) in training set and 42.11% (16/38) in test set. Multivariate logistic regression analysis showed that open abdominal surgery, surgical instruments using unipolar electrosurgical scalpel, number of removed lymph node > 20, pelvic and para-aortic lymphadenectomy, drainage days > 3 days, postoperative chemoradio- therapy were the risk factors for pelvic lymphocysts formation within 14 days after cervical cancer surgery (P<0.05) . The importance of the predictive variables, in descending order, were lymph node dissection range, postoperativeradiotherapy/chemotherapy, number of lymph nodes removed, drainage duration, use of unipolar electrosurgical scalpel, and use of open abdominal surgery. The SVM model consisted of open abdominal surgery, unipolarelectrosurgical scalpel, number of removed lymph node, lymphadenectomy range, drainage days, postoperativeradiotherapy and chemotherapy. The accuracy (88.22%, 78.95%) and AUC (0.785, 0.776) of SVM model in predicting the formation of pelvic lymphocysts after cervical cancer surgery in both the training and test sets were higherthan those of logistic regression model (75.56%, 71.05%) and AUC (0.712, 0.694) . The difference of AUC between the two models was statistically significant (training set: Z=8.655,P=0.001; test set: Z=2.454,P=0.003). Conclusion The accuracy, sensitivity, specificity, AUC and other indicators of SVM model in predicting the formation of pelvic lymphocysts within 14 days after surgery in patients with cervical cancer are better than logistic regression model.
keywords: Cervical cancer Pelvic lymphocysts Logistic regression Support vector machine Lymphadenectomy Postoperative radiotherapy Postoperative chemotherapy
文章编号: 中图分类号:R713.4 文献标志码:A
基金项目:辽宁省科技计划联合计划(2023JH2/101700089)
Author Name | Affiliation |
WANG Jiao, GAO Hui, ZHAO Bo | Department of Obstetrics and Gynecology, Northern Theater Command General Hospital, Shenyang, Liaoning 110000, China |
Author Name | Affiliation |
WANG Jiao, GAO Hui, ZHAO Bo | Department of Obstetrics and Gynecology, Northern Theater Command General Hospital, Shenyang, Liaoning 110000, China |
引用文本: