Construction of risk early-warning model for postoperative lymphedema in breast cancer patients and research on hierarchical prevention strategy
乳腺癌术后淋巴水肿风险预警模型的构建及分级预防策略研究

摘要

目的 构建乳腺癌术后淋巴水肿风险预警模型的构建及分级预防策略研究。方法 选取2024年3月-2025年3月我院收治的60例乳腺癌手术患者，采用回顾性分析结合前瞻性随访的方法，通过单因素Logistic回归筛选乳腺癌术后淋巴水肿的相关危险因素，经多因素Logistic回归构建风险预警模型并验证其效能，依据模型风险评分制定分级预防策略，比较不同风险等级患者的淋巴水肿发生率。结果 60例构建的风险预警模型预测效能良好（AUC=0.892，95%CI：0.801~0.954，灵敏度83.33%，特异度85.71%。依据模型评分将患者分为低危（0~3分）、中危（4~6分）、高危（7~10分）三级，低危组22例、中危组25例、高危组13例。结论 本研究构建的乳腺癌术后淋巴水肿风险预警模型具有较高的预测效能，依据模型实施分级预防策略可针对性降低不同风险等级患者的淋巴水肿发生率，为临床乳腺癌术后淋巴水肿的精准防控提供了科学、可行的方法，值得临床推广应用。

Abstract

Objective To establish a risk early-warning model for postoperative lymphedema in breast cancer patients and study the hierarchical prevention strategy.
Methods 60 patients with breast cancer who were treated in our hospital from March 2024 to March 2025 were selected. A retrospective analysis combined with a prospective follow-up was conducted. Univariate Logistic regression was used to screen for risk factors related to lymphedema after breast cancer surgery. A risk early warning model was constructed using multivariate Logistic regression, and its effectiveness was verified. Graded prevention strategies were formulated according to the model risk score, and the incidence of lymphedema in patients with different risk levels was compared.
Results The risk warning model constructed for 60 cases had good predictive performance (AUC=0.892, 95% CI: 0.801-0.954, sensitivity 83.33%, specificity 85.71%). According to the model score, patients were divided into three levels: low-risk (0-3 points), moderate risk (4-6 points), and high-risk (7-10 points), with 22 cases in the low-risk group, 25 cases in the moderate risk group, and 13 cases in the high-risk group.
Conclusion   The risk early-warning model of postoperative lymphedema of breast cancer constructed in this study has a high predictive efficiency. The implementation of hierarchical prevention strategy based on the model can reduce the incidence of lymphedema in patients with different risk levels, which provides a scientific and feasible method for accurate prevention and control of postoperative lymphedema of breast cancer, and is worthy of clinical promotion and application.