| Objective To explore the construction and verification of a nomogram model for individualized prediction of postoperative recurrence risk of hysteroscopy for uterine fibroids of childbearing age. Methods A total of 289 patients of childbearing age who underwent hysteroscopic myomectomy in Department of Gynecology, Suzhou Kowloon Hospital from January 2016 to April 2018 were selected and followed up regularly within three years after the operation. Finally, 236 patients with complete follow-up data were included as the research objects. The clinical data of all included patients were collected and divided into recurrence group (n=49) and non-recurrence group (n=187) according to whether the patients recurred during the follow-up period. Through univariate and multivariate logistic regression analysis, the risk factors affecting postoperative recurrence were determined, and then a nomogram model was established and verified. Results Among the 236 patients included, the recurrence rate within three years was 20.76% (49/236). Univariate analysis showed that there were statistically significant differences between the two groups of patients in terms of uterine adhesions, fibroids number, types of fibroids, fibroids diameter, ER, PR, and Bcl-2 levels (P< 0.05). Multivariate logistic regression analysis showed that intrauterine adhesions, number of fibroids, types of fibroids, fibroids diameter, ER, PR, and Bcl-2 levels were all independent influencing factors for postoperative recurrence of hysteroscopy in uterine fibroids of childbearing age (P< 0.05). According to the above seven independent influencing factors, a nomogram model was constructed and verified, and it was found that the AUC of this nomogram model predicting the risk of recurrence in patients with uterine fibroids of childbearing age was 0.971 (95% CI: 0.951~0.990), the sensitivity was 0.898, and the specificity was 0.936. Hosmer-Lemeshow deviation test showed χ2=2.866 (P=0.943). Bootstrap internal verification showed that the MAE of the calibration curve of the nomogram model was 0.015. Conclusion The nomogram model constructed based on the risk factors of postoperative recurrence in patients with uterine fibroids of childbearing age has good discrimination and calibration, and good predictive ability. It can be used for patients with high risk of recurrence after hysteroscopic uterine fibroids removal, providing reference for the formulation of screening and intervention programs. |
