Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection

doi:10.3748/wjg.v31.i11.102387

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World Journal of Gastroenterology

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World J Gastroenterol. Mar 21, 2025; 31(11): 102387
Published online Mar 21, 2025. doi: 10.3748/wjg.v31.i11.102387

Table 1 Baseline demographic and clinicopathological characteristics of all patients, n (%)

Variables	Training set (n = 1186)	Validation set (n = 508)	Prospective set (n = 166)	P value
Gender
Female	474 (40.0)	194 (38.2)	67 (40.4)	0.769
Male	712 (60.0)	314 (61.8)	99 (59.6)
Age, median (IQR)	56.00 (49.00, 63.00)	56.50 (49.00, 64.00)	56.00 (50.00, 63.00)	0.948
BMI, median (IQR)	24.20 (22.31, 26.40)	24.32 (22.49, 26.47)	24.22 (22.02, 26.67)	0.445
Hypertension
No	924 (77.9)	368 (72.4)	128 (77.1)	0.051
Yes	262 (22.1)	140 (27.6)	38 (22.9)
Diabetes
No	1057 (89.1)	448 (88.2)	143 (86.1)	0.497
Yes	129 (10.9)	60 (11.8)	23 (13.9)
CHD
No	1117 (94.2)	468 (92.1)	153 (92.2)	0.231
Yes	69 (5.8)	40 (7.9)	13 (7.8)
Family history
No	1088 (91.7)	479 (94.3)	149 (89.8)	0.089
Yes	98 (8.3)	29 (5.7)	17 (10.2)
Cigarette preference
No	972 (82.0)	413 (81.3)	137 (82.5)	0.921
Yes	214 (18.0)	95 (18.7)	29 (17.5)
Alcohol preference
No	971 (81.9)	422 (83.1)	133 (80.1)	0.669
Yes	215 (18.1)	86 (16.9)	33 (19.9)
Constipation
No	1086 (91.6)	470 (92.5)	146 (88.0)	0.185
Yes	100 (8.4)	38 (7.5)	20 (12.0)
Diarrhea
No	918 (77.4)	399 (78.5)	128 (77.1)	0.860
Yes	268 (22.6)	109 (21.5)	38 (22.9)
Hemafecia
No	1112 (93.8)	479 (94.3)	160 (96.4)	0.397
Yes	74 (6.2)	29 (5.7)	6 (3.6)
Anatomical location
Proximal colon	261 (22.0)	117 (23.0)	54 (32.5)	0.023
Distal colon	505 (42.6)	208 (40.9)	69 (41.6)
Total colon	420 (35.4)	183 (36.0)	43 (25.9)
Number of polyps
< 3	672 (56.7)	276 (54.3)	106 (63.9)	0.099
≥ 3	514 (43.3)	232 (45.7)	60 (36.1)
Number of adenomas
0	392 (33.1)	150 (29.5)	57 (34.3)	0.542
1-2	545 (46.0)	237 (46.7)	74 (44.6)
≥ 3	249 (21.0)	121 (23.8)	35 (21.1)
Size
< 0.5	400 (33.7)	157 (30.9)	118 (71.1)	< 0.001
0.5-1	627 (52.9)	266 (52.4)	37 (22.3)
> 1	159 (13.4)	85 (16.7)	11 (6.6)
Endoscopic classification
I	512 (43.2)	201 (39.6)	99 (59.6)	< 0.001
II	442 (37.3)	191 (37.6)	54 (32.5)
III-IV	232 (19.6)	116 (22.8)	13 (7.8)
Hazard classification
Non-neoplastic polyps	394 (33.2)	152 (29.9)	72 (43.4)	0.002
Non-progressive adenoma	564 (47.6)	250 (49.2)	79 (47.6)
Progressive adenoma	228 (19.2)	106 (20.9)	15 (9.0)
Concomitant gastric polyp
No	761 (64.2)	356 (70.1)	127 (76.5)	0.001
Yes	425 (35.8)	152 (29.9)	39 (23.5)
H. pylori
No	699 (58.9)	308 (60.6)	104 (62.7)	0.586
Yes	487 (41.1)	200 (39.4)	62 (37.3)
Hyperlipidemia
No	810 (68.3)	341 (67.1)	117 (70.5)	0.714
Yes	376 (31.7)	167 (32.9)	49 (29.5)
Uric acid levels
Normal	1105 (93.2)	475 (93.5)	153 (92.2)	0.839
Elevated	81 (6.8)	33 (6.5)	13 (7.8)
TBIL, median (IQR)	11.90 (9.30, 15.78)	12.00 (9.30, 15.62)	9.90 (5.90, 13.97)	< 0.001
TBA, median (IQR)	3.00 (1.80, 4.68)	3.30 (1.90, 4.93)	2.90 (1.80, 5.60)	0.149
hsCRP, median (IQR)	0.60 (0.50, 1.30)	0.60 (0.50, 1.30)	0.50 (0.50, 1.40)	0.775
CEA
Normal	1150 (97.0)	496 (97.6)	161 (97.0)	0.741
Elevated	36 (3.0)	12 (2.4)	5 (3.0)
CA724
Normal	1137 (95.9)	487 (95.9)	155 (93.4)	0.323
Elevated	49 (4.1)	21 (4.1)	11 (6.6)
CA199
Normal	1160 (97.8)	499 (98.2)	163 (98.2)	0.833
Elevated	26 (2.2)	9 (1.8)	3 (1.8)
CA242
Normal	1154 (97.3)	491 (96.7)	159 (95.8)	0.492
Elevated	32 (2.7)	17 (3.3)	7 (4.2)

BMI: Body mass index (kg/m²); CHD: Coronary heart disease; TBIL: Total Bilirubin (μmol/L); TBA: Total bile acid (μmol/L); hsCRP: Hypersensitive C-reactive protein (mg/L); CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; H. pylori: Helicobacter pylori; IQR: Interquartile range.

Table 2 Univariate and multivariate logistic regression analysis of colorectal polyp recurrence 1 year after Endoscopic mucosal resection

Variables	Univariable analysis		Multivariable analysis
Variables	OR (95%CI)	P value	OR (95%CI)	P value
Age	1.04 (1.03-1.05)	< 0.001^a	1.05 (1.03-1.06)	< 0.001^a
Gender (%)
Female	Reference	-	Reference	-
Male	1.73 (1.37-2.19)	< 0.001^a	0.94 (0.69-1.27)	0.684
BMI	1.07 (1.03-1.11)	< 0.001^a	1.05 (1-1.1)	0.056
Hypertension (%)
No	Reference	-	Reference	-
Yes	1.75 (1.31-2.33)	< 0.001^a	1.07 (0.75-1.52)	0.722
Diabetes (%)
No	Reference	-	Reference	-
Yes	1.42 (0.98-2.08)	0.067	-	-
CHD (%)
No	Reference	-	Reference	-
Yes	2.33 (1.34-4.04)	0.003^a	1.41 (0.73-2.72)	0.300
Family history (%)
No	Reference	-	Reference	-
Yes	10.07 (4.84-20.96)	< 0.001^a	11.34 (5.09-25.26)	< 0.001^a
Cigarette preference (%)
No	Reference	-	Reference	-
Yes	5.14 (3.5-7.54)	< 0.001^a	3.92 (2.50-6.14)	< 0.001^a
Alcohol preference (%)
No	Reference	-	Reference	-
Yes	1.34 (0.99-1.82)	0.056	-	-
Constipation (%)
No	Reference	-	Reference	-
Yes	1.05 (0.69-1.58)	0.831	-	-
Diarrhea (%)
No	Reference	-	Reference	-
Yes	1.40 (1.06-1.85)	0.018^a	1.42 (1.02-1.99)	0.038^a
Hemafecia (%)
No	Reference	-	Reference	-
Yes	1.24 (0.76-2.00)	0.389	-	-
Anatomical location (%)
Proximal colon	Reference	-	Reference	-
Distal colon	1.08 (0.80-1.45)	0.630	1.09 (0.77-1.05)	0.635
Total colon	2.16 (1.57-2.96)	< 0.001^a	0.92 (0.60-1.40)	0.683
Number of polyps (%)
< 3	Reference	-	Reference	-
≥ 3	3.10 (2.43-3.96)	< 0.001^a	1.54 (1.07-2.21)	0.019^a
Number of adenomas (%)
0	Reference	-	Reference	-
1-2	2.02 (1.55-2.63)	< 0.001^a	0.44 (0.10-1.95)	0.279
≥ 3	8.96 (6.00-13.38)	< 0.001^a	1.01 (0.22-4.70)	0.989
Size (%)
< 0.5	Reference	-	Reference	-
0.5-1	2.18 (1.69-2.81)	< 0.001^a	2.05 (1.50-2.80)	< 0.001^a
> 1	6.65 (4.25-10.43)	< 0.001^a	3.98 (2.02-7.86)	< 0.001^a
Endoscopic classification (%)
I	Reference	-	Reference	-
II	1.40 (1.09-1.81)	0.010^a	0.71 (0.50-1.02)	0.066
III-IV	3.32 (2.35-4.68)	< 0.001^a	0.60 (0.32-1.11)	0.106
Hazard classification (%)
Non-neoplastic polyps	Reference	-	Reference	-
Non-progressive adenoma	2.47 (1.89-3.21)	< 0.001^a	4.48 (1.02-19.73)	0.048^a
Progressive adenoma	6.07 (4.17-8.84)	< 0.001^a	5.29 (1.07-26.20)	0.041^a
Concomitant gastric polyp (%)
No	Reference	-	Reference	-
Yes	0.90 (0.71-1.15)	0.397	-	-
H. pylori (%)
No	Reference	-	Reference	-
Yes	1.89 (1.49-2.4)	< 0.001^a	1.82 (1.37-2.42)	< 0.001^a
Hyperlipidemia (%)
No	Reference	-	Reference	-
Yes	1.48 (1.15-1.90)	0.002^a	1.20 (0.87-1.64)	0.263
Uric acid levels (%)
Normal	Reference	-	Reference	-
Elevated	2.08 (1.26-3.41)	0.004^a	1.15 (0.63-2.09)	0.646
TBIL	1.01 (1.00-1.04)	0.259	-	-
TBA	1.02 (0.99-1.05)	0.298	-	-
hsCRP	1.03 (0.98-1.06)	0.164	-	-
CEA (%)
Normal	Reference	-	Reference	-
Elevated	1.10 (0.56-2.16)	0.773	-	-
CA724 (%)
Normal	Reference	-	Reference	-
Elevated	0.96 (0.54-1.72)	0.899	-	-
CA199 (%)
Normal	Reference	-	Reference	-
Elevated	0.92 (0.42-2.00)	0.824	-	-
CA242 (%)
Normal	Reference	-	Reference	-
Elevated	0.60 (0.30-1.22)	0.162	-	-

^aP value < 0.05.

Table 3 Comparison of the performance of different models in training set, validation set and prospective set

Model		AUC	Sensitivity	Specificity	Accuracy	Precision	F1 score
Training set	LR	0.803	0.733	0.728	0.731	0.774	0.753
	DT	0.754	0.806	0.613	0.721	0.726	0.764
	RF	0.861	0.727	0.835	0.775	0.849	0.784
	SVM	0.808	0.720	0.753	0.734	0.788	0.752
	XGB	0.909	0.756	0.904	0.820	0.907	0.824
Validation set	LR	0.809	0.743	0.686	0.719	0.756	0.750
	DT	0.799	0.785	0.723	0.758	0.788	0.786
	RF	0.902	0.750	0.918	0.823	0.923	0.828
	SVM	0.819	0.743	0.705	0.726	0.767	0.755
	XGB	0.921	0.788	0.914	0.843	0.923	0.850
Prospective set	LR	0.779	0.568	0.847	0.711	0.780	0.657
	DT	0.812	0.765	0.729	0.747	0.765	0.747
	RF	0.943	0.667	0.988	0.831	0.982	0.794
	SVM	0.791	0.617	0.824	0.723	0.769	0.685
	XGB	0.963	0.840	0.941	0.892	0.932	0.883

LR: Logistic regression; DT: Decision Tree; RF: Random forest; SVM: Support vector machine; XGB: Extreme Gradient Boosting; AUC: Area under the curve.

Citation: Shi YH, Liu JL, Cheng CC, Li WL, Sun H, Zhou XL, Wei H, Fei SJ. Construction and validation of machine learning-based predictive model for colorectal polyp recurrence one year after endoscopic mucosal resection. World J Gastroenterol 2025; 31(11): 102387
URL: https://www.wjgnet.com/1007-9327/full/v31/i11/102387.htm
DOI: https://dx.doi.org/10.3748/wjg.v31.i11.102387