Validation of a Nomogram for Predicting the Probability of Carcinoma in Patients With Intraductal Papillary Mucinous Neoplasm in 180 Pancreatic Resection Patients at 3 High-Volume Centers
Validation of a Nomogram for Predicting the Probability of Carcinoma in Patients With Intraductal Papillary Mucinous Neoplasm in 180 Pancreatic Resection Patients at 3 High-Volume Centers
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DOI：
10.1097/mpa.0000000000000269
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发表时间：
2015-04-01
期刊：
影响因子：
2.9
通讯作者：
Yanagisawa, Akio
中科院分区：
文献类型：
--
作者：
Shimizu, Yasuhiro;Yamaue, Hiroki;Yanagisawa, Akio
目的：我们之前发表了一个预测导管内乳头状粘液瘤（IPMN）患者癌的nomogram。当前研究的目的是在多个机构的外部队列患者中验证该nomogram。方法：收集3家医院行胰腺切除术的180例IPMN患者的临床资料。分析了四个重要的预测因素（性别、病变类型、结节高度和胰液细胞学）。结果：180例患者中，主胰管型IPMN 66例（36.7%），分支胰管型IPMN 114例（63.3%）。最终病理诊断良性IPMN 95例（52.8%），恶性IPMN 85例（47.2%）。该模型的受者工作特征曲线下面积为0.760。主胰管型IPMN的受者工作特征曲线下面积为0.747，分支胰管型IPMN的受者工作特征曲线下面积为0.752。当预测概率大于10%时，该模型的敏感性为80.0%，特异性为57.9%。结论：在外部验证的患者队列中，预测IPMN患者患癌概率的nomogram是准确的。
Objective: We previously published a nomogram for prediction of carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). The objective of the current study was to validate this nomogram in an external cohort of patients at multiple institutions.Methods: The clinical details of 180 patients with IPMN who underwent a pancreatic resection at 3 hospitals were collected. Four significant predictive factors (sex, lesion type, nodule height, and pancreatic juice cytology) were analyzed.Results: Of the 180 patients, 66 (36.7%) had a main pancreatic duct-type IPMN and 114 (63.3%) had a branch pancreatic duct-type IPMN. The final pathological diagnosis was benign IPMN in 95 (52.8%) patients and malignant IPMN in 85 (47.2%) patients. The area under the receiver operating characteristic curve for the model was 0.760. The area under the receiver operating characteristic curve of the IPMN nomogram for prediction of malignancy was 0.747 in main pancreatic duct-type IPMN and 0.752 in branch pancreatic duct-type IPMN. The sensitivity and specificity of the model were 80.0% and 57.9%, respectively, when the predictive probability of more than 10% was used to indicate the presence of carcinoma.Conclusions: This nomogram for predicting the probability of carcinoma in patients with IPMN was accurate in an external validation patient cohort.