Analysis and external validation of a nomogram to predict peritoneal dissemination in gastric cancer
Analysis and external validation of a nomogram to predict peritoneal dissemination in gastric cancer
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DOI：
10.21147/j.issn.1000-9604.2020.02.07
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发表时间：
2020-04-01
影响因子：
5.1
通讯作者：
Peng, Junsheng
中科院分区：
文献类型：
--
作者：
Chen, Xijie;Chen, Shi;Peng, Junsheng
目的：腹膜播散是一种常规影像学诊断困难的疾病。方法：回顾性分析2001 - 2010年中山大学附属第六医院收治的1,112例胃癌患者作为发展集，2010 - 2016年中山大学附属第六医院收治的474例胃癌患者作为验证集。分析与胃癌腹膜播散（GCPD）相关的临床病理变量。我们使用逻辑回归分析来确定腹膜播散的独立危险因素。然后，我们构建了预测GCPD的诺模图，并使用受试者工作特征（ROC）曲线定义其预测值。外部验证进行了验证的nomogram.Results的适用性：在总数，250例患者被组织学确定为腹膜传播。Logistic回归分析显示，年龄、性别、肿瘤部位、肿瘤大小、印戒细胞癌（SRCC）、T分期、N分期和Borrmann IV型（Borrmann IV）是腹膜播散的独立危险因素。我们构建了一个由这八个因素组成的诺模图来预测GCPD，并发现了一个乐观的预测能力，C指数为0.791，曲线下面积（AUC）为0.791，95%置信区间（95%CI）为0.762-0.820。结果发现，在外部验证集也是hopeful.Conclusions：我们构建了一个高度敏感的诺模图，可以帮助临床医生在早期诊断GCPD，并作为优化临床管理策略的参考。
Objective: Peritoneal dissemination is difficult to diagnose by conventional imaging technologies. We aimed to construct a nomogram to predict peritoneal dissemination in gastric cancer (GC) patients.Methods: We retrospectively analyzed 1,112 GC patients in Sun Yat-sen University Cancer Center between 2001 and 2010 as the development set and 474 patients from The Sixth Affiliated Hospital, Sun Yat-sen University between 2010 and 2016 as the validation set. The clinicopathological variables associated with gastric cancer with peritoneal dissemination (GCPD) were analyzed. We used logistic regression analysis to identify independent risk factors for peritoneal dissemination. Then, we constructed a nomogram for the prediction of GCPD and defined its predictive value with a receiver operating characteristic (ROC) curve. External validation was performed to validate the applicability of the nomogram.Results: In total, 250 patients were histologically identified as having peritoneal dissemination. Logistic regression analysis demonstrated that age, sex, tumor location, tumor size, signet-ring cell carcinoma (SRCC), T stage, N stage and Borrmann classification IV (Borrmann IV) were independent risk factors for peritoneal dissemination. We constructed a nomogram consisting of these eight factors to predict GCPD and found an optimistic predictive capability, with a C-index of 0.791, an area under the curve (AUC) of 0.791, and a 95% confidence interval (95% CI) of 0.762-0.820. The results found in the external validation set were also promising.Conclusions: We constructed a highly sensitive nomogram that can assist clinicians in the early diagnosis of GCPD and serve as a reference for optimizing clinical management strategies.