Clinical value of predicting bleeding after endoscopic submucosal dissection for early esophageal cancer

Table 1 Comparison of clinical data between the two groups of patients

Factors	Bleeding group (n = 29)	Non-bleeding group (n = 149)	t/χ2	P value
Age (years)	61.21 ± 12.35	60.55 ± 11.56	0.277	0.782
Sex, n (%)			0.035	0.852
Male	16 (55.17)	85 (57.15)
Female	13 (44.83)	6442.95
Diabetes, n (%)			1.074	0.300
Yes	6 (20.69)	45 (30.20)
No	23 (79.31)	104 (69.80)
History of chronic kidney disease, n (%)			1.542	0.214
Yes	6 (20.69)	18 (12.08)
No	23 (79.31)	131 (87.92)
Preoperative anemia, n (%)			0.013	0.910
Yes	5 (17.24)	27 (18.12)
No	24 (82.76)	122 (81.88)
Tumor size [cm; n (%)]			12.010	< 0.001
< 3	10 (34.48)	47 (31.54)
≥ 3	19 (65.52)	102 (68.46)
Infiltration depth, n (%)			1.717	0.424
M1	26 (89.66)	122 (81.88)
M2	3 (10.34)	20 (13.42)
M3	0 (0.00)	74.70
Tumor location, n (%)			0.656	0.720
Upper esophagus	10 (34.48)	41 (27.52)
Middle esophagus	5 (17.24)	32 (21.48)
Lower esophagus	14 (48.28)	76 (51.00)
Tumor morphology, n (%)			2.675	0.263
Uplift	13 (44.83)	84 (56.38)
Depression	13 (44.83)	59 (39.60)
Flat	3 (10.34)	6 (4.03)
Intraoperative bleeding, n (%)			6.622	0.010
Yes	8 (27.59)	17 (11.41)
No	21 (72.41)	132 (88.59)
Operation time (minute)	50.10 ± 3.32	49.22 ± 2.95
Postoperative anticoagulant use, n (%)			0.543	0.461
No	17 (58.62)	98 (65.77)
Yes	12 (41.38)	51 (34.23)

Table 2 Comparison of preoperative laboratory examination indexes between the two groups of patients

Indicators	Bleeding group (n = 29)	Non-bleeding group (n = 149)	t value	P value
CRP (mg/L)	52.14 ± 6.60	48.77 ± 5.37	2.981	0.003
Platelet count (× 109/L)	193.32 ± 37.55	207.55 ± 39.21	1.800	0.074
Neutrophils (× 109/L)	6.33 ± 1.55	5.89 ± 1.43	1.534	0.127
Lymphocytes (× 109/L)	1.88 ± 0.46	1.91 ± 0.49	0.203	0.839
Hematocrit (%)	38.56 ± 3.22	39.10 ± 3.52	0.765	0.446
Hemoglobin (g/L)	125.68 ± 16.22	128.31 ± 17.88	0.735	0.463
White blood cell count (× 109/L)	7.88 ± 1.90	7.25 ± 1.63	1.877	0.062
PT (second)	12.50 ± 2.32	12.22 ± 2.45	0.569	0.570
APTT (second)	35.65 ± 3.67	34.85 ± 3.23	1.195	0.234
Fibrinogen (g/L)	3.53 ± 0.52	3.61 ± 0.60	0.653	0.515

CRP: C-reactive protein; PT: Prothrombin time; APTT: Activated partial thromboplastin time.

Table 3 Comparison of bleeding after endoscopic submucosal dissection trend from Japan scores between bleeding group and non-bleeding group in patients with early esophageal cancer

Item	Bleeding group (n = 29)	Non-bleeding group (n = 149)	t/χ2	P value
BEST-J score (points)	1.97 ± 1.12	1.55 ± 0.93	2.829	0.005
BEST-J score distribution, n (%)			11.494	0.042
0	1 (3.45)	12 (8.05)
1	8 (27.59)	77 (51.68)
2	15 (51.72)	47 (31.54)
3	2 (6.90)	10 (6.71)
4	2 (6.90)	2 (1.34)
5	1 (3.45)	1 (0.67)
BEST-J risk, n (%)			9.025	0.029
Low risk	9 (31.03)	89 (59.73)
Medium risk	15 (51.72)	47 (31.54)
High risk	4 (13.79)	12 (8.05)
Extremely high risk	1 (3.45)	1 (0.67)

BEST-J: Bleeding after endoscopic submucosal dissection trend from Japan.

Table 4 Multivariate analysis of factors affecting bleeding after endoscopic submucosal dissection for early esophageal cancer

Factors	β	SE	Wals χ2	P value	OR	95%CI
Tumor size	1.544	0.456	11.455	< 0.001	4.685	1.916-11.458
Surgical bleeding	1.341	0.556	5.824	0.016	3.825	1.287-11.370
CRP	0.114	0.040	8.116	0.004	1.120	1.036-1.211
Constant	-8.332	2.107	15.630	< 0.001	0.000	-

CRP: C-reactive protein.

Table 5 Comparison of the predictive effects of the gradient boosting machine model and bleeding after endoscopic submucosal dissection trend from Japan score on bleeding after endoscopic submucosal dissection in patients with early esophageal cancer

Project	AUC (90%CI)	Sensitivity	Specificity	Cut-off value	P value	95%CI
BEST-J score	0.653	0.759	0.738	0.166	< 0.001	0.545-0.762
GBM prediction model	0.818	0.724	0.792	0.191	0.009	0.729-0.906

AUC: Area under the curve; BEST-J: Bleeding after endoscopic submucosal dissection trend from Japan; GBM: Gradient boosting machine.