回顾性分析2013年1月至2024年6月在锦州市中心医院收治的PTGBD术后行LC的老年急性胆囊炎患者的临床资料。采用Logistic回归(LR)、支持向量机(SVM)、决策树(DT)、随机森林(RF)和人工神经网络算法(ANN)对得到的数据集进行预测模型的构建。使用交叉验证进行内部验证并采用曲线下面积和Brier评分测量值对模型的分化程度和校准度进行评价和比较。最终确定了6个危险因素,包括:年龄、体温、白细胞、胆囊壁厚度、碱性磷酸酶及血尿素氮,并在此基础上建立预测模型,通过比较不同模型的敏感性、特异性、阳性预测值、阴性预测值、临床决策曲线(DCA)和校准曲线,5个模型均显示出良好的预测性能和稳定性,可被视为临床决策的辅助手段。The clinical data of elderly patients with acute cholecystitis who underwent LC after PTGBD and were admitted to the Central Hospital of Jinzhou from January 2013 to June 2024 were retrospectively analyzed. Logistic Regression (LR), Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), and Artificial Neural Network (ANN) were used to construct the prediction model of the obtained dataset. Internal validation was performed using cross-validation, and the degree of differentiation and calibration of the models were evaluated and compared using the area under the curve and Brier score measurements. Finally, six risk factors were identified, including age, body temperature, white blood cells, gallbladder wall thickness, alkaline phosphatase, and blood urea nitrogen, and a prediction model was established on this basis and by comparing the sensitivity, specificity, positive predictive value, negative predictive value, clinical decision curve (DCA) and calibration curve of different models, the five models showed good predictive performance and stability, which can be regarded as an auxiliary means for clinical decision-making.
目的分析爪蟾驱动蛋白样蛋白2靶蛋白(TPX2)在肝细胞癌(HCC)中的表达及临床意义。方法采用UALCAN数据库分析TPX2 m RNA和蛋白在HCC组织中的表达情况;K-M Plot数据库分析TPX2表达情况对HCC患者预后的影响;HPA免疫组化分析TPX2蛋白在HCC组织中的表达情况;GEPIA及UALCAN数据库分析HCC组织中TPX2与肿瘤蛋白p53(TP53)表达的相关性;ACLBI数据库分析TPX2在HCC组织中的表达水平及对患者预后的预测价值。结果UALCAN数据库分析结果显示,不同分期和分级HCC组织中TPX2 mRNA表达水平均高于正常组织,差异均有统计学意义(P﹤0.05)。K-M Plot数据库分析结果显示,TPX2低表达HCC患者的无复发生存期(RFS)、总生存期(OS)、无进展生存期(PFS)及疾病特异性生存期(DSS)均优于TPX2高表达患者,差异均有统计学意义(P﹤0.05)。HPA数据库免疫组化分析结果显示,HCC组织中TPX2蛋白阳性表达高于正常肝组织。UALCAN与GEPIA数据库分析结果显示,HCC组织中TPX2与TP53表达呈正相关(r=0.34,P﹤0.05),且TP53突变组TPX2 m RNA表达水平高于TP53未突变组,差异有统计学意义(P﹤0.05)。ACLBI数据库分析结果显示,随着TPX2表达的增高,患者预后不良风险增加;TPX2低表达HCC患者的OS明显优于TPX2高表达患者,差异有统计学意义(P﹤0.01);TPX2表达预测HCC患者1、3、5年OS的受试者工作特征(ROC)曲线的曲线下面积(AUC)分别为0.731(95%CI:0.659~0.803)、0.664(95%CI:0.588~0.739)和0.644(95%CI:0.551~0.738)。结论TPX2是一种癌基因,不利于HCC患者的预后,可作为HCC诊断与预后的生物标志物。
