关键词: 肥胖； 乳腺癌； 手术； 切口脂肪液化； 影响因素； 列线图

Abstract: Objective To explore the influencing factors of fat liquefaction in the surgical incision of obese breast cancer, and to construct a risk early warning Nomogram model and verify its effectiveness.Methods The clinical data of 327 patients with obese breast cancer treated in our hospital from January 2021 to June 2024 were retrospectively analyzed, they were divided into the occurrence group (n=72) and the non-occurrence group (n=255) according to whether fat liquefaction occurred in the postoperative incision, and the influencing factors of fat liquefaction in the surgical incision of obese breast cancer were analyzed by multivariate Logistic regression model.The R software was applied to construct a risk early warning nomogram, and the receiver operating characteristic curve (ROC) and calibration curve were drawn to verify the predictive efficacy of the model for the risk of fat liquefaction in the surgical incision of obese breast cancer.Results The age, BMI, the proportion of diabetes mellitus, the proportion of intraoperative cutting instruments (electrotome), serum albumin and hemoglobin in occurrence group were (52.19±7.42) years old, (32.79±2.05)kg/m², 40.28%, 45.83%, (35.89±5.11) g/L and (110.49±12.88) g/L, respectively, and those in non-occurrence group were (46.45±6.25) years old, (30.47±1.93) kg/m², 20.39%, 27.45%, (40.71±4.14) g/L and (119.75±11.52) g/L], respectively.The difference between the two groups was statistically significant (P< 0.05).Age, BMI, diabetes, serum albumin were the influencing factors of fat liquefaction in the surgical incision of obese breast cancer (P< 0.05).The area under the curve, sensitivity and specificity of the the risk early warning Nomogram model for predicting fat liquefaction in the surgical incision of obese breast cancer were 0.926, 90.28%, 82.75%, respectively.The calibration curve showed that the prediction probability of the model was close to the actual probability, and the Hosmer-Lemeshow goodness of fit test showed that it was well fitted (χ²=1.891, P=0.329).Conclusion Age, BMI, diabetes, hemoglobin and intraoperative are the influencing factors of fat liquefaction in the surgical incision of obese breast cancer, the risk early warning Nomogram model has good prediction efficiency based on this.

Key words: obesity; breast cancer; surgery; incision fat liquefaction; influencing factors; nomogram model