{
  "abstract": "Endoscopic submucosal dissection (ESD) for early esophageal neoplasia may cause strictures that impair eating and quality of life. Existing models rely on anatomical factors; the value of inflammatory-nutritional markers like the C-reactive protein-to-albumin ratio (CAR) remains unclear. We aimed to develop and internally validate a CAR-based nomogram for post-ESD stricture. This retrospective single-center study (2015-2024) included consecutive ESD patients with early esophageal neoplasia, excluding those with additional therapy, multiple lesions, comorbidities, recent infections, steroids, or loss to follow-up. Stricture: dysphagia or inability to pass a 9.8-mm scope within 12 months. CAR = preoperative C-reactive protein / albumin. The model was developed on the full cohort and internally validated via 1,000 bootstrap resamples (optimism-corrected). Logistic regression built the nomogram. Performance: area under the curve (AUC), sensitivity/specificity, calibration (Brier), and decision curve analysis (DCA). Of 111 patients, 36 (32.4%) developed stricture. Independent predictors were infiltration depth (< M2 vs. ≥ M2), longitudinal length (<3.75 vs. ≥3.75 cm), circumferential extent (<0.5, 0.5-0.75, ≥0.75), and CAR (<0.03 vs. ≥0.03). The nomogram achieved an AUC of 0.866 [95% confidence interval (CI): 0.800-0.931]. At the optimal cutoff, the sensitivity was 73.2% (95% CI: 56.9-85.4), specificity 83.1% (95% CI: 72.5-90.4), Brier score 0.122, and optimism-corrected AUC 0.889. Calibration and decision curves showed good performance and net benefit. CAR independently predicts post-ESD stricture. The nomogram is a promising preliminary risk-stratification tool, but requires external validation before its routine clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo, China.",
    "Department of Gastroenterology, Ningbo Medical Center Lihuili Hospital, Ningbo, China.",
    "Department of Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo Medical Center Lihuili Hospital, Ningbo, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mengqiu Tang"
    },
    {
      "affs": [
        1
      ],
      "name": "Chen Wang"
    },
    {
      "affs": [
        2
      ],
      "name": "Yang Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Tian Chen",
      "orcid": "0000-0001-8490-600X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6yy3ahntnda1p.bib",
  "cited_by": 0,
  "doi": "10.21037/jtd-2026-1725",
  "fulltext_url": "https://europepmc.org/articles/PMC13740736",
  "id": "6yy3ahntnda1p",
  "issns": [
    "2072-1439",
    "2077-6624"
  ],
  "landing_url": "https://europepmc.org/article/MED/42996922",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7223361950",
  "pdf_url": "https://europepmc.org/articles/PMC13740736?pdf=render",
  "pmcid": "PMC13740736",
  "pmid": "42996922",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6yy3ahntnda1p.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42996922",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42996922"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Development and internal validation of a nomogram incorporating C-reactive protein-to-albumin ratio for predicting esophageal stricture after endoscopic submucosal dissection in early esophageal neoplasia.",
  "title_text": "Development and internal validation of a nomogram incorporating C-reactive protein-to-albumin ratio for predicting esophageal stricture after endoscopic submucosal dissection in early esophageal neoplasia.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/6yy3ahntnda1p",
  "venue": "Journal of thoracic disease",
  "versions": []
}