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基于 IDA 的结直肠癌不良结局影响因素的因果效应 分析.

Objective The aim of this study was to identify the direct and indirect factors influencing adverse outcomes in patients with colorectal cancer after treatment, and to explore the causal effects of these factors on adverse outcomes, providing a basis for improving patient prognosis. Methods Medical...

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Published in:Practical Oncology Journal Vol. 39; no. 6; pp. 471 - 478
Main Authors: 白山奇, 刘美娜, 宋莉
Format: research tables/charts Journal Article
Published: Journal of Practical Oncology Editorial Office 2025
Online Access:View this record in EBSCOhost
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        10023070
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      jtl: Practical Oncology Journal
      issn: 10023070
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      dt: 2025
      vid: 39
      iid: 6
      pid: 46664
      pub: Journal of Practical Oncology Editorial Office
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        191548679
        191548679
        191548679
        10.11904/j.issn.1002-3070.2025.06.003
        191548679
      ppf: 471
      ppct: 7
      formats:
      tig:
        atl: 基于 IDA 的结直肠癌不良结局影响因素的因果效应 分析.
      aug:
        au:
          白山奇
          刘美娜
          宋莉
        affil: 哈尔滨医科大学公共卫生学院卫生统计学教研室(哈尔滨 150081).
      sug:
        subj:
          Colorectal Neoplasms Prognosis
          Colorectal Neoplasms Mortality
          Algorithms
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          China
          Tertiary Health Care
          Models, Statistical
          Chemotherapy, Cancer
          Surgery, Operative
          Radiotherapy, Adjuvant
          Body Mass Index
          Alcohol Drinking
          Length of Stay
          Neoplasm Recurrence, Local
          Neoplasm Metastasis
          Hospitalization
          Causal Attribution
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab:
        Objective The aim of this study was to identify the direct and indirect factors influencing adverse outcomes in patients with colorectal cancer after treatment, and to explore the causal effects of these factors on adverse outcomes, providing a basis for improving patient prognosis. Methods Medical record information of patients admitted to Harbin Medical University Cancer Hospital and diagnosed with colorectal cancer from 2013 to 2015 was collected. Adverse outcomes were defined as death, metastasis, or recurrence within two years after treatment. The fast greedy equivalence search algorithm was used to construct a causal graphical model and analyze the direct and indirect factors influencing adverse outcomes. Based on this, the intervention calculus when the directed acyclic graph is absent(IDA)algorithm was employed to evaluate the causal effects of these factors on adverse outcomes. Results A total of 2, 332 patients were included, with an average age of(68. 0±10. 9) years and an adverse outcome incidence of 6. 22%. The causal graph contained 20 nodes and 36 edges. The direct factors influencing adverse outcomes included chemotherapy, pathological type, surgical treatment, and length of hospital stay( |IDA| values were 0. 039, 0. 059, 0. 255, and 0. 054, respectively). The indirect influencing factors included age, alcohol consumption, body mass index, differentiation degree, radiotherapy, and surgery nature( |IDA| values were 0. 011, 0. 021, 0. 012, 0. 042, 0. 021, and 0. 030, respectively). Conclusions Based on identifying key factors influencing adverse outcomes in colorectal cancer through the causal graph, the IDA algorithm can quantify the causal effects of influencing factors on adverse outcomes. The study suggests that in the clinical treatment of colorectal cancer, increasing the acceptance rate of surgery and chemotherapy in patients without surgical or chemotherapy contraindications can reduce the incidence of adverse outcomes and thereby improve prognosis.
        目的 识别结直肠癌患者治疗后不良结局的直接与间接影响因素, 并探讨这些因素与不良结局之间的因果效 应, 为改善患者不良结局提供依据。 方法 收集 2013 年至 2015 年在哈尔滨医科大学附属肿瘤医院入院并确诊为结直肠癌 的患者病例信息, 将治疗后两年内发生死亡、转移或复发定义为不良结局。 以快速等价贪婪搜索算法构建因果图模型并分 析不良结局的直接与间接影响因素, 在此基础上采用无因果图时的干预演算 (intervention calculus when the directed acyclic graph is absent, IDA) 算法评估影响因素对不良结局的因果效应。 结果 共纳入 2 332 例患者, 平均年龄 (68. 0±10. 9) 岁, 不 良结局发生率 6. 22%。 因果图包含 20 个节点、36 条边; 不良结局发生的直接影响因素包括化疗、病理类型、手术治疗及住院 天数 (|IDA| 分别为 0. 039、0. 059、0. 255、0. 054);间接影响因素包括年龄、饮酒、身体质量指数、分化程度、放疗、手术性质 (|IDA|分别为 0. 011、0. 021、0. 012、0. 042、0. 021、0. 030)。 结论 在因果图识别结直肠癌不良结局的关键因素基础上, IDA 算法可量化影响因素对不良结局的因果效应。 研究提示在结直肠癌的临床治疗中, 提高无手术、化疗禁忌症患者的手术及 化疗接受率可降低不良结局发生率, 从而改善预后。
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: Chinese
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