基于体检队列的胃炎风险预测模型

doi:10.6040/j.issn.1671-7554.0.2019.001

摘要/Abstract

摘要： 目的构建基于体检者的胃炎风险预测模型。方法在 2004年5月到2016年9月山东多中心健康管理纵向观测队列中选取初次体检未诊断为胃炎的体检者33 416人,通过多元逐步回归进行变量选择,建立Cox比例风险模型。最后通过十折交叉法进行内部验证。结果在观察期间有842例体检者出现新发胃炎情况,发病率为2.52%,发病密度为18.74‰,最后纳入模型的变量包括:年龄、幽门螺旋杆菌感染、白蛋白水平、嗜碱性粒细胞百分数以及淋巴细胞计数。预测模型的ROC曲线的AUC值为0.691(95%CI:0.670~0.712)。模型十折交叉验证后的AUC值为0.673(95%CI:0.652~0.694)。结论建立基于体检队列的胃炎风险模型的预测能力较好。

关键词: 体检队列, 胃炎, 风险预测模型, Cox回归, 十折交叉验证

Abstract: Objective To construct a risk prediction model based on the physical examination data. Methods A total of 33 416 non-gastritic subjects who received their first physical examination during May 2004 and Sep. 2016 in multi-centers were involved. The Cox proportional risk model was adopted to perform variable selection by stepwise method. Ten-fold cross validation was used to test the stability of the model. Results In the observation period, 842 new gastritis cases were observed. The incidence rate was 2.52% and incidence density was 18.74‰. The variables included age, helicobacter pylori infection, albumin, basophils percentage and lymphocyte count. In the receiver operating characteristic(ROC)curve, the area under the curve(AUC)was 0.691(95%CI: 0.671-0.710). The AUC after the ten-fold cross-validation was 0.673(95%CI: 0.652-0.694). Conclusion The model we constructed can effectively predict the gastritis risk.

Key words: Examination cohort, Gastritis, Risk prediction model, Cox regression, Ten-fold cross-validation

中图分类号:

R573.3

徐源佑,杨亚超,王春霞,马晓天,薛付忠,刘言训,王萍. 基于体检队列的胃炎风险预测模型[J]. 山东大学学报 (医学版), 2019, 57(6): 112-116.

XU Yuanyou, YANG Yachao, WANG Chunxia, MA Xiaotian, XUE Fuzhong, LIU Yanxun, WANG Ping. A risk prediction model of gastritis based on examination cohort[J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 112-116.

参考文献

[1] 房静远, 刘文忠, 李兆申,等. 中国慢性胃炎共识意见(2012年,上海)[J]. 中国医学前沿杂志(电子版), 2013,5(7): 44-55. FANG Jingyuan, LIU Wenzhong, LI Zhaoshen, et al. Consensus on chronic gastritis in China(2012, Shanghai)[J]. Chinese Journal of Frontier Medicine(Electronic Edition), 2013, 5(7): 44-55.
[2] 刘艳萍, 王明月, 牟春笋, 等. 青少年慢性胃炎危险因素分析382例[J]. 世界华人消化杂志, 2005, 13(15): 1921-1923. LIU Yanping, WANG Mingyue, MOU Chunsun, et al. Analysis of 382 cases of risk factors for chronic gastritis in adolescents [J]. World Chinese Journal of Digestology,2005,13(15): 1921-1923.
[3] Li ZW, Wu Y, Sun Y,et al.Inflammatory cytokine gene polymorphisms increase the risk of atrophic gastritis and intestinal metaplasia[J]. World J Gastroenterol, 2010,16(14):1788-1794.
[4] 李慕然, 刘艳迪, 唐涛,等. 幽门螺杆菌和慢性胃炎胃黏膜病理变化的关系研究[J]. 天津医药, 2015, 43(1): 54-56. LI Muran, LIU Yandi, TANG Tao, et al. Study on the relationship between the pathologic change of chronic atrophic gastritis helicobacer pylori[J]. Tianjin Medicine Journal, 2015, 43(1): 54-56.
[5] Ohyauchi M. The polymorphism interleukin-8 -251 A/T influences the susceptibility of Helicobacter pylori related gastric diseases in the Japanese population[J]. Gut,2005, 54(3): 330-335.
[6] Taguchi A, Ohmiya N, Shirai K, et al. Interleukin-8 promoter polymorphism increases the risk of atrophic gastritis and gastric cancer in Japan[J]. Cancer Epidemiol Biomarkers Prev, 2005, 14(11): 2487-2493.
[7] Li Z, Li J. Local expressions of TGF-beta1, TGF-beta1RI, CTGF, and Smad-7 in Helicobacter pylori-associated gastritis[J]. Scand J Gastroenterol, 2006, 41(9):1007-1012.
[8] Inoue I, Kato J, Tamai H, et al. Helicobacter pylori-related chronic gastritis as a risk factor for colonic neoplasms[J]. World J Gastroenterol, 2014, 20(6): 1485-1492.
[9] Vannella, Lucy. Risk for gastric neoplasias in patients with chronic atrophic gastritis: A critical reappraisal[J]. World J Gastroenterol, 2012, 18(12): 1279.
[10] 王滨, 孙天燕, 王晓宇, 等. 胆汁反流性胃炎临床研究与分析[J]. 医学研究杂志, 2010, 39(1): 96-98. WANG Bin, SUN Tianyan, WANG Xiaoyu, et al. Clinic study and analysis of bile reflux gastritis[J]. Journal of Medical Research, 2010, 39(1): 96-98.
[11] Redéen S, Petersson F, Kechagias S, et al. Natural history of chronic gastritis in a population-based cohort[J]. Scand J Gastroenterol, 2010, 45(5): 540-549.
[12] De Vries AC, Meijer GA, Looman CW, et al. Epidemiological trends of pre-malignant gastric lesions: a long-term nationwide study in the Netherlands[J]. Gut, 2007, 56(12): 1665-1670.
[13] Inoue M, Tajima K, Matsuura A, et al. Severity of chronic atrophic gastritis and subsequent gastric cancer occurrence: a 10-year prospective cohort study in Japan[J]. Cancer Lett,2000,161(1):105-112.
[14] 侯政昆, 刘凤斌, 李培武,等. 刘凤斌教授治疗慢性萎缩性胃炎的病例系列挖掘分析和经验总结[J]. 中国中药杂志, 2015, 40(11): 2227-2234. HOU Zhengkun, LIU Fengbin, LI Peiwu, et al. Mining analysis and experience summary for chronic atrophic gastritis cases treated by Professor LIU Feng-bin[J]. China Journal of Chinese Materia Medica,2015,40(11): 2227-2234.
[15] Zhang L, Hou YH, Wu K, et al. Proteomic analysis reveals molecular biological details in varioliform gastritis without Helicobacter pylori infection[J]. World J Gastroenterol, 2010, 16(29): 3664-3673.
[16] Sampieri CL, Pe(~overn)a SDL, Ochoalara M, et al. Expression of matrix metalloproteinases 2 and 9 in human gastric cancer and superficial gastritis[J]. World J Gastroenterol, 2010,16(12):1500-1505.
[17] 刘力生. 中国高血压防治指南2010[J]. 中华高血压杂志,2011,19(8): 701-743.
[18] 刘文忠. “幽门螺杆菌胃炎京都全球共识”解读[J]. 胃肠病学, 2015, 20(8): 449-456. LIU Wenzhong. Discussion of gastroenterology and hepatology[J]. Chinese Journal of Gastroenterology, 2015, 20(8): 449-456.
[19] 于永强, 程秀莲, 周金才,等. 慢性萎缩性胃炎患者的危险因素与临床治疗效果观察研究[J]. 世界中医药, 2015(1): 635-636. YU Yongqiang, CHENG Xiulian, ZHOU Jincai, et al. Risk factors and clinical therapeutic effects of patients with chronic atrophic gastritis[J]. World Journal of Traditional Chinese Medicine, 2015(1): 635-636.
[20] 樊乃驹. 萎缩性胃炎危险因素调查[J]. 南昌大学学报(医学版), 1989, 3: 89-91. FAN Naiju. Investigation on risk factors of atrophic gastritis[J]. Journal of Nanchang University Medical Sciences, 1989, 3: 89-91.
[21] 杨其法, 王海英, 沈红燕, 等. 杭州市余杭区居民慢性胃炎危险因素的病例-对照研究[J]. 中国慢性病预防与控制, 2006, 14(1):27-29. YANG Qifa, WANG Haiying, SHEN Hongyan, et al. A case-control study on risk factors for chronic gastritis in Yuhang district[J].Chinese Journal of Prevention and Control of Chronic Diseases, 2006, 14(1): 27-29.
[22] Sun GY, Wu JX, Wu JS, et al. Caveolin-1, E-cadherin and β-catenin in gastric carcinoma, precancerous tissues and chronic non-atrophic gastritis[J]. Chin J Cancer Res, 2012, 24(1): 23-28.
[23] Furuta T, El-Omar E M, Xiao F, et al. Interleukin 1beta polymorphisms increase risk of hypochlorhydria and atrophic gastritis and reduce risk of duodenal ulcer recurrence in Japan[J]. Gastroenterology, 2002, 123(1): 92-105.
[24] Veijola LI, Oksanen AM, Sipponen PI, et al. Association of autoimmune type atrophic corpus gastritis with Helicobacter pylori infection[J]. World J Gastroenterol, 2010, 16(1): 83-88.
[25] Wang P, Ji R, Yu T, et al. Classification of histological severity of Helicobacter pylori-associated gastritis by confocal laser endomicroscopy[J]. World J Gastroenterol, 2010, 16(41): 5203-5210.
[26] Bodger K, Crabtree JE. Helicobacter pylori and gastric inflammation[J]. Br Med Bull, 1998,54(1):139-150.
[27] 吴燕洁. 慢性萎缩性胃炎转归风险预测模型的临床应用[D]. 上海: 上海交通大学, 2013.
[28] 郝秀英. 慢性胃炎发病年龄初探[J]. 中国中西医结合消化杂志,1995, 3(2): 109. HAO Xiuying. Preliminary study on the age of onset of chronic gastritis[J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 1995, 3(2): 109.
[29] 聂晴, 范钟麟, 张瑛. 幽门螺杆菌在慢性胃炎病理类型及年龄分布上的特点[J]. 中国高原医学与生物学杂志, 1997,18(3): 171-173. NIE Qing, FAN Zhonglin, ZHANG Ying. Characteristics of Helicobacter pylori in pathological types and age distribution of chronic gastritis[J]. Chinese Journal of Plateau Medical and Biology, 1997, 18(3): 171-173.
[30] 吕娇燕, 何睿. 嗜碱性粒细胞对Th2细胞免疫应答调节的研究进展[J]. 国际免疫学杂志, 2012, 35(2): 99-102. LÜ Jiaoyan, HE Rui. Progress in the regulation of basophils on immune response in Th2 cells[J]. International Journal of Immunology, 2012, 35(2): 99-102.

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