Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations.
Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations.
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中国人群胃癌个性化筛查风险评估工具的开发、验证和评价。
DOI：
10.1186/s12916-023-02864-0
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发表时间：
2023-04-27
期刊：
影响因子：
9.3
通讯作者：
Jin, Guangfu
中科院分区：
文献类型：
--
作者：
Zhu, Xia;Lv, Jun;Zhu, Meng;Yan, Caiwang;Deng, Bin;Yu, Canqing;Guo, Yu;Ni, Jing;She, Qiang;Wang, Tianpei;Wang, Jiayu;Jiang, Yue;Chen, Jiaping;Hang, Dong;Song, Ci;Gao, Xuefeng;Wu, Jian;Dai, Juncheng;Ma, Hongxia;Yang, Ling;Chen, Yiping;Song, Mingyang;Wei, Qingyi;Chen, Zhengming;Hu, Zhibin;Shen, Hongbing;Ding, Yanbing;Li, Liming;Jin, Guangfu
胃癌（GC）个性化内镜筛查缺乏有效的风险预测模型。我们的目的是开发、验证和评估基于问卷的GC风险评估工具，用于中国人群的风险预测和分层。在这项三阶段多中心研究中，我们首先通过 Cox 回归模型选择符合条件的变量，并根据来自中国嘉道理生物库（CKB，发展队列）的 416,343 名受试者（年龄 40-75 岁）的回归系数构建 GC 风险评分 (GCRS)。在同一年龄范围内，我们在另一个独立常州队列（验证队列）的 13,982 名受试者以及扬州内窥镜筛查项目的 5348 名受试者中验证了 GCRS 的有效性。最后，我们根据发展队列中的 GCRS 分布将参与者分为低风险（底部 20%）、中度风险（20-80%）和高风险（顶部 20%）组。使用 11 个基于问卷的变量的 GCRS 显示，两个队列的 Harrell’s C 指数分别为 0.754（95% CI，0.745-0.762）和 0.736（95% CI，0.710-0.761）。在验证队列中，GCRS 低（≤ 13.6）、中（13.7~30.6）和高（≥ 30.7）个体的 10 年风险分别为 0.34%、1.05% 和 4.32%。在内窥镜筛查计划中，GC 的检出率从低 GCRS 个体的 0.00%、中 GCRS 个体的 0.27% 到高 GCRS 个体的 2.59% 不等。 81.6% 的 GC 病例来自高 GCRS 组，占所有筛查参与者的 28.9%。 GCRS可以成为中国定制GC内镜筛查的有效风险评估工具。自行进行胃癌风险评估 (RESCUE) 是一种在线工具，旨在帮助 GCRS 的使用。在线版本包含可在 10.1186/s12916-023-02864-0 获取的补充材料。
Effective risk prediction models are lacking for personalized endoscopic screening of gastric cancer (GC). We aimed to develop, validate, and evaluate a questionnaire-based GC risk assessment tool for risk prediction and stratification in the Chinese population. In this three-stage multicenter study, we first selected eligible variables by Cox regression models and constructed a GC risk score (GCRS) based on regression coefficients in 416,343 subjects (aged 40–75 years) from the China Kadoorie Biobank (CKB, development cohort). In the same age range, we validated the GCRS effectiveness in 13,982 subjects from another independent Changzhou cohort (validation cohort) as well as in 5348 subjects from an endoscopy screening program in Yangzhou. Finally, we categorized participants into low (bottom 20%), intermediate (20–80%), and high risk (top 20%) groups by the GCRS distribution in the development cohort. The GCRS using 11 questionnaire-based variables demonstrated a Harrell’s C-index of 0.754 (95% CI, 0.745–0.762) and 0.736 (95% CI, 0.710–0.761) in the two cohorts, respectively. In the validation cohort, the 10-year risk was 0.34%, 1.05%, and 4.32% for individuals with a low (≤ 13.6), intermediate (13.7~30.6), and high (≥ 30.7) GCRS, respectively. In the endoscopic screening program, the detection rate of GC varied from 0.00% in low-GCRS individuals, 0.27% with intermediate GCRS, to 2.59% with high GCRS. A proportion of 81.6% of all GC cases was identified from the high-GCRS group, which represented 28.9% of all the screened participants. The GCRS can be an effective risk assessment tool for tailored endoscopic screening of GC in China. Risk Evaluation for Stomach Cancer by Yourself (RESCUE), an online tool was developed to aid the use of GCRS. The online version contains supplementary material available at 10.1186/s12916-023-02864-0.
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影响因子：
5.2
作者：
Kawakatsu Y;Koyanagi YN;Oze I;Kasugai Y;Morioka H;Yamaguchi R;Ito H;Matsuo K
通讯作者：
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作者：
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通讯作者：
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