External Validation of a Nomogram Using RENAL Nephrometry Score to Predict High Grade Renal Cell Carcinoma
External Validation of a Nomogram Using RENAL Nephrometry Score to Predict High Grade Renal Cell Carcinoma
复制标题
使用 RENAL 肾测量评分预测高级别肾细胞癌的列线图的外部验证
DOI：
10.1016/j.juro.2011.12.099
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发表时间：
2012-05-01
影响因子：
6.6
通讯作者：
Ye, Ding-Wei
中科院分区：
文献类型：
--
作者：
Wang, Hong-Kai;Zhu, Yao;Ye, Ding-Wei
目的：开发了一种使用RENAL（[R]半径最大直径（cm）、[E]外生性/内生性、[N]肿瘤与集合系统或窦的距离（mm）、[A]内/后性、[L]相对于极线的位置和[H]ilar）肾功能测定评分的新型列线图，以预测高级别肾细胞癌。在内部评价中表现良好。我们外部验证的预测model.Materials和方法：我们确定了一个队列的391例肾细胞癌手术切除在我们的机构从2008年至2011年。Fuhrman分级由一位经验丰富的泌尿生殖道病理学家进行审查，放射学图像由2位资深泌尿科医生独立评估。使用2级系统，高级别疾病定义为Fuhrman III/IV级。预测模型的统计性能进行了评价的歧视，校准和临床usefuls.Results：的391例患者45.5%被认为是有高级别的肿瘤。列线图的外部验证显示AUC为0.73。校准图显示，高级别疾病的预测概率与观察到的频率具有一致性。在决策曲线分析的预测模型提供了一个上级净效益和减少在大于20%的概率thresholds.Conclusions：我们确认的诺模图的预测价值，使用肾肾功能评分，以确定高级别肾细胞癌在一个独立的队列。需要进一步的研究，以评估其性能使用头对头比较肾活检结果。
Purpose: A novel nomogram using the RENAL ([R]adius maximal diameter in cm, [E]xophytic/endophytic properties, [N]earness of the tumor to the collecting system or sinus in mm, [A]nterior/Posterior, [L]ocation relative to the polar lines and [H]ilar) nephrometry score was developed to predict high grade renal cell carcinoma. It showed good performance in internal evaluation. We externally validated the prediction model.Materials and Methods: We identified a cohort of 391 Chinese patients in whom renal cell carcinoma was surgically resected at our institution from 2008 to 2011. Fuhrman grade was reviewed by an experienced genitourinary pathologist and radiological images were independently assessed by 2 senior urologists. Using a 2-tiered system high grade disease was defined as Fuhrman grade III/IV. The statistical performance of the prediction model was evaluated by discrimination, calibration and clinical usefulness.Results: Of the 391 patients 45.5% were considered to have high grade tumors. External validation of the nomogram revealed an AUC of 0.73. The calibration plot showed that the predicted probability of high grade disease had concordance comparable to the observed frequency. On decision curve analysis the prediction model provided a superior net benefit and reduction at a greater than 20% probability threshold.Conclusions: We confirm the predictive value of the nomogram using the RENAL nephrometry score to identify high grade renal cell carcinoma in an independent cohort. Further research is required to evaluate its performance using a head-to-head comparison with renal biopsy results.