Predicting the risk of endometrial cancer in postmenopausal women presenting with vaginal bleeding: the Norwich DEFAB risk assessment tool
Predicting the risk of endometrial cancer in postmenopausal women presenting with vaginal bleeding: the Norwich DEFAB risk assessment tool
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DOI：
10.1038/sj.bjc.6605620
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发表时间：
2010-04-13
影响因子：
8.8
通讯作者：
Nieto, J. J.
中科院分区：
文献类型：
--
作者：
Burbos, N.;Musonda, P.;Nieto, J. J.
背景：这项研究的目的是展示从病史和超声评估子宫内膜常规收集的临床数据在开发一种算法来预测绝经后阴道出血妇女子宫内膜癌风险的纵向使用。方法：这项前瞻性研究收集了3047名绝经后出血妇女的数据。收集有关子宫内膜癌危险因素存在的数据，并进行单变量和多变量分析。结果：年龄分布范围从35岁到97岁，中位数59岁。共有149名妇女(占总数的5%)被诊断为子宫内膜癌。子宫内膜癌组的女性明显更有可能年龄更大、BMI更高、反复出血、糖尿病、高血压或既往乳腺癌病史。研究人员使用最佳模型选择方法来选择最好的癌症预测因素，并使用Logistic回归分析创建了一个模型‘Norwich DEFAB’，这是一种临床预测子宫内膜癌的规则。计算的Norwich DEFAB评分范围从0到9。Norwich DEFAB值等于或大于3的阳性预测值(PPV)为7.78%，阴性预测值(NPV)为98.2%，而评分等于或大于5的患者的阳性预测值(PPV)为11.9%，阴性预测值(NPV)为97.8%。结论：结合临床信息和我们对绝经后阴道出血患者的调查工具，临床医生可以计算出子宫内膜恶性肿瘤的预测风险，并优先进行后续的临床研究。《英国癌症杂志》(2010)102,1201-1206。DOI：10.1038/sj.bjc.6605620 www.bjancer.com 2010年3月30日在线发布(C)2010年英国癌症研究
BACKGROUND: This study aimed to show the longitudinal use of routinely collected clinical data from history and ultrasound evaluation of the endometrium in developing an algorithm to predict the risk of endometrial carcinoma for postmenopausal women presenting with vaginal bleeding.METHODS: This prospective study collected data from 3047 women presenting with postmenopausal bleeding. Data regarding the presence of risk factors for endometrial cancer was collected and univariate and multivariate analyses were performed.RESULTS: Age distribution ranged from 35 to 97 years with a median of 59 years. A total of 149 women (5% of total) were diagnosed with endometrial carcinoma. Women in the endometrial cancer group were significantly more likely to be older, have higher BMI, recurrent episodes of bleeding, diabetes, hypertension, or a previous history of breast cancer. An investigator best model selection approach was used to select the best predictors of cancer, and using logistic regression analysis we created a model, 'Norwich DEFAB', which is a clinical prediction rule for endometrial cancer. The calculated Norwich DEFAB score can vary from a value of 0 to 9. A Norwich DEFAB value equal to or greater than 3 has a positive predictive value (PPV) of 7.78% and negative predictive value (NPV) of 98.2%, whereas a score equal to or greater than 5 has a PPV of 11.9% and NPV of 97.8%.CONCLUSION: The combination of clinical information with our investigation tool for women with postmenopausal vaginal bleeding allows the clinician to calculate a predicted risk of endometrial malignancy and prioritise subsequent clinical investigations. British Journal of Cancer (2010) 102, 1201-1206. doi: 10.1038/sj.bjc.6605620 www.bjcancer.com Published online 30 March 2010 (C) 2010 Cancer Research UK