| Citation: |
XIE Liang, LIU Chang, LI Jianhua, LI Jianhui, HAO Xin, HUA Haiyang. Risk Factor and Risk Prediction Modeling of Rectal Neuroendocrine Tumors[J]. Cancer Research on Prevention and Treatment, 2025, 52(7): 598-604. DOI: 10.3971/j.issn.1000-8578.2025.24.1089
|
To analyze the risk factors associated with the occurrence of rectal neuroendocrine tumors (RNETs) and construct a risk prediction model.
Clinical data of patients who underwent electronic colonoscopy were collected. The clinical information on patients with and without RNETs were compared, and potential risk factors for RNETs were identified. Binary logistic regression was performed to analyze the relevant risk factors and construct a risk prediction model.
Among 164 patients, 66 were diagnosed with RNETs, and 98 who did not have such a condition were randomly selected. Univariate logistic regression analysis revealed that age, fatty liver, anxiety and depression, total cholesterol, triglyceride levels, and carcinoembryonic antigen (CEA) were significant factors influencing the occurrence of RNETs (P<0.05). Multivariate logistic regression analysis identified age (P=0.015), anxiety and depression (P=0.031), cholesterol level (P=0.009), fatty liver (P=0.001), and CEA (P<0.001) as independent risk factors for RNETs. The participants were randomly divided into training and test sets at a 7:3 ratio. The training set was used to construct a nomogram-based risk prediction model, and the testing set was used for internal validation. The area under the curve values for the training and testing sets were 0.843 and 0.772, respectively (P>0.05). These findings indicate a good discriminative performance. The calibration curves for the training and testing sets were in good agreement with the 45° standard line, which suggests that the predicted probabilities were consistent with the actual outcomes. Decision curve analysis showed that the model provided a high net benefit within a threshold range of 0.2 to 0.7 for clinical decision making.
Young age, fatty liver, high CEA levels, high cholesterol levels, and anxiety and depression are independent risk factors for RNETs. The nomogram model constructed based on these risk factors exhibits a strong capability to predict the occurrence of RNETs, and clinical intervention can be considered based on the predicted probability values.
Competing interests: The authors declare that they have no competing interests.
| [1] |
Osagiede O, Habermann E, Day C, et al. Factors associated with worse outcomes for colorectal neuroendocrine tumors in radical versus local resections[J]. J Gastrointest Oncol, 2020, 11(5): 836-846. doi: 10.21037/jgo-20-193
|
| [2] |
Xu Z, Wang L, Dai S, et al. Epidemiologic Trends of and Factors Associated With Overall Survival for Patients With Gastroenteropancreatic Neuroendocrine Tumors in the United States[J]. JAMA Netw Open, 2021, 4(9): e2124750. doi: 10.1001/jamanetworkopen.2021.24750
|
| [3] |
Das S, Dasari A. Epidemiology, Incidence, and Prevalence of Neuroendocrine Neoplasms: Are There Global Differences?[J]. Curr Oncol Rep, 2021, 23(4): 43. doi: 10.1007/s11912-021-01029-7
|
| [4] |
Zhao F, Huang L, Wang Z, et al. Epidemiological trends and novel prognostic evaluation approaches of patients with stage II-IV colorectal neuroendocrine neoplasms: A population-based study with external validation[J]. Front Endocrinol(Lausanne), 2023, 14: 1061187. doi: 10.3389/fendo.2023.1061187
|
| [5] |
Modica R, Liccardi A, Minotta R, et al. Therapeutic strategies for patients with neuroendocrine neoplasms: current perspectives[J]. Expert Rev Endocrinol Metab, 2022, 17(5): 389-403. doi: 10.1080/17446651.2022.2099840
|
| [6] |
Wang FG, Jiang Y, Liu C, et al. Comparison between Endoscopic Submucosal Dissection and Transanal Endoscopic Microsurgery in Early Rectal Neuroendocrine Tumor Patients: A Meta-Analysis[J]. J Invest Surg, 2023, 36(1): 2278191. doi: 10.1080/08941939.2023.2278191
|
| [7] |
刘玥, 张梦慈, 陈玉根. 结直肠神经内分泌肿瘤研究进展[J]. 齐齐哈尔医学院学报, 2019, 40(8): 1016-1019. [Liu Y, Zhang MC, Chen YG. Pay attention to colorectal neuroendocrine tumors[J]. Qiqihaer Yi Xue Yuan Xue Bao, 2019, 40(8): 1016-1019.] doi: 10.3969/j.issn.1002-1256.2019.08.041
Liu Y, Zhang MC, Chen YG. Pay attention to colorectal neuroendocrine tumors[J]. Qiqihaer Yi Xue Yuan Xue Bao, 2019, 40(8): 1016-1019. doi: 10.3969/j.issn.1002-1256.2019.08.041
|
| [8] |
Pyo JH, Hong SN, Min BH, et al. Evaluation of the risk factors associated with rectal neuroendocrine tumors: a big data analytic study from a health screening center[J]. J Gastroenterol, 2016, 51(12): 1112-1121. doi: 10.1007/s00535-016-1198-9
|
| [9] |
席娜, 丛春莉, 青兰, 等. 内镜在结直肠神经内分泌肿瘤诊治中的研究进展[J]. 医学研究杂志, 2024, 53(1): 16-20. [Xi N, Cong CL, Qing L, et al. Research progress of endoscopy in the diagnosis and treatment of colorectal neuroendocrine tumors[J]. Yi Xue Yan Jiu Za Zhi, 2024, 53(1): 16-20.]
Xi N, Cong CL, Qing L, et al. Research progress of endoscopy in the diagnosis and treatment of colorectal neuroendocrine tumors[J]. Yi Xue Yan Jiu Za Zhi, 2024, 53(1): 16-20.
|
| [10] |
Hassan MM, Phan A, Li D, et al. Risk factors associated with neuroendocrine tumors: A U. S. -based case-control study[J]. Int J Cancer, 2008, 123(4): 867-873.
|
| [11] |
Hemminki K, Li X. Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden[J]. Cancer, 2001, 92(8): 2204-2210. doi: 10.1002/1097-0142(20011015)92:8<2204::AID-CNCR1564>3.0.CO;2-R
|
| [12] |
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13, 715 carcinoid tumors[J]. Cancer, 2003, 97(4): 934-959. doi: 10.1002/cncr.11105
|
| [13] |
Matsui K, Iwase T, Kitagawa M. Small, polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment[J]. Am J Gastroenterol, 1993, 88(11): 1949-1953.
|
| [14] |
Jetmore AB, Ray JE, Gathright JB Jr, et al. Rectal carcinoids: the most frequent carcinoid tumor[J]. Dis Colon Rectum, 1992, 35(8): 717-725. doi: 10.1007/BF02050318
|
| [15] |
Li AF, Hsu CY, Li A, et al. A 35-year retrospective study of carcinoid tumors in Taiwan: differences in distribution with a high probability of associated second primary malignancies[J]. Cancer, 2008, 112(2): 274-283. doi: 10.1002/cncr.23159
|
| [16] |
Shim KN, Yang SK, Myung SJ, et al. Atypical endoscopic features of rectal carcinoids[J]. Endoscopy, 2004, 36(4): 313-316. doi: 10.1055/s-2004-814202
|
| [17] |
Liu Z, Lin C, Suo C, et al. Metabolic dysfunction-associated fatty liver disease and the risk of 24 specific cancers[J]. Metabolism, 2022, 127: 154955. doi: 10.1016/j.metabol.2021.154955
|
| [18] |
Zhao K, Zhou S, Shi X, et al. Potential metabolic monitoring indicators of suicide attempts in first episode and drug naive young patients with major depressive disorder: a cross-sectional study[J]. BMC Psychiatry, 2020, 20(1): 387. doi: 10.1186/s12888-020-02791-x
|
| [19] |
Shaker NM, Sultan M, Mohamed MY, et al. Lipid Profile and Impulsivity in Suicidal Patients with Major Depressive Disorder[J]. Arch Suicide Res, 2021, 25(3): 641-656. doi: 10.1080/13811118.2020.1746456
|
| [20] |
Jung YS, Yun KE, Chang Y, et al. Risk factors associated with rectal neuroendocrine tumors: a cross-sectional study[J]. Cancer Epidemiol Biomarkers Prev, 2014, 23(7): 1406-1413. doi: 10.1158/1055-9965.EPI-14-0132
|
Figures(4) / Tables(3)
This work is licensed under a Creative Commons Attribution 3.0 License.
Copyright © Editorial Department of Cancer Prevention Research 鄂公网安备 42011102005013号 鄂ICP备2022015867号
Supported by: Beijing Renhe Information Technology Co., Ltd. 
DownLoad: