Development and External Validation of a Preoperative Nomogram for Predicting Lateral Pelvic Lymph Node Metastasis in Patients With Advanced Lower Rectal Cancer.
Development and External Validation of a Preoperative Nomogram for Predicting Lateral Pelvic Lymph Node Metastasis in Patients With Advanced Lower Rectal Cancer.
复制标题
用于预测晚期下直肠癌患者侧盆腔淋巴结转移的术前列线图的开发和外部验证
DOI：
10.3389/fonc.2022.930942
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发表时间：
2022
影响因子：
4.7
通讯作者：
Tang, Jianqiang
中科院分区：
文献类型：
--
作者：
Zhang, Lei;Shi, Feiyu;Hu, Chenhao;Zhang, Zhe;Liu, Junguang;Liu, Ruihan;She, Junjun;Tang, Jianqiang
关键词：
术前预测盆腔外侧淋巴结（LPLN）转移是决定进展期低位直肠癌患者进一步治疗策略的关键。在这项研究中，我们建立了一个诺模图模型，术前预测LPLN转移，然后外部验证该模型的准确性。本研究共纳入287例接受LPLN剥离的直肠癌患者。其中，北京大学第一医院的200例患者被纳入开发集，西安交通大学第一附属医院的87例患者被纳入独立外部验证集。采用多因素Logistic回归分析建立列线图。基于其校准、区分和临床实用性评估列线图的性能。五个因素（分化等级，壁外血管侵犯，肿瘤的距离，肛门边缘，直肠周围淋巴结的状态，和LPLN的最大短轴直径）被确定，并列入诺模图。基于分析开发的列线图显示出稳健的区分，受试者工作特征曲线下面积（AUC）为0.878（95% CI，0.824-0.932）。验证集显示出良好的区分度，AUC为0.863（95% CI，0.779-0.948）。决策曲线分析表明，诺模图具有临床应用价值。本研究提出了一个临床-影像学列线图，结合临床病理危险因素和影像学特征。经外部验证，诺模图模型的预测能力令人满意，有望成为评估晚期低位直肠癌患者LPLN转移风险的一种方便、直观、个性化的临床工具。
The preoperative prediction of lateral pelvic lymph node (LPLN) metastasis is crucial in determining further treatment strategies for advanced lower rectal cancer patients. In this study, we established a nomogram model to preoperatively predict LPLN metastasis and then externally validated the accuracy of this model. A total of 287 rectal cancer patients who underwent LPLN dissection were included in this study. Among them, 200 patients from the Peking University First Hospital were included in the development set, and 87 patients from the First Affiliated Hospital of Xi’an Jiaotong University were included in the independent external validation set. Multivariate logistic regression analysis was used to develop the nomogram. The performance of the nomogram was assessed based on its calibration, discrimination, and clinical utility. Five factors (differentiation grade, extramural vascular invasion, distance of the tumor from the anal verge, perirectal lymph node status, and largest short-axis diameter of LPLN) were identified and included in the nomogram. The nomogram developed based on the analysis showed robust discrimination with an area under the receiver operating characteristic curve (AUC) of 0.878 (95% CI, 0.824–0.932). The validation set showed good discrimination with an AUC of 0.863 (95% CI, 0.779–0.948). Decision curve analysis showed that the nomogram was clinically useful. The present study proposed a clinical-imaging nomogram with a combination of clinicopathological risk factors and imaging features. After external verification, the predictive power of the nomogram model was satisfactory, and it is expected to be a convenient, visual, and personalized clinical tool for assessing the risk of LPLN metastasis in advanced lower rectal cancer patients.
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影响因子：
3.3
作者：
Tomita N;Ishida H;Tanakaya K;Yamaguchi T;Kumamoto K;Tanaka T;Hinoi T;Miyakura Y;Hasegawa H;Takayama T;Ishikawa H;Nakajima T;Chino A;Shimodaira H;Hirasawa A;Nakayama Y;Sekine S;Tamura K;Akagi K;Kawasaki Y;Kobayashi H;Arai M;Itabashi M;Hashiguchi Y;Sugihara K;Japanese Society for Cancer of the Colon, Rectum
通讯作者：
Japanese Society for Cancer of the Colon, Rectum
影响因子：
2.6
作者：
Ishibe, Atsushi;Ota, Mitsuyoshi;Endo, Itaru
通讯作者：
Endo, Itaru
影响因子：
2.8
作者：
Lim, Seok-Byung;Yu, Chang Sik;Kim, Jin Cheon
通讯作者：
Kim, Jin Cheon
影响因子：
3.3
作者：
Kim, JH;Beets, GL;Beets-Tan, RGH
通讯作者：
Beets-Tan, RGH
影响因子：
45.3
作者：
Schrag, Deborah;Weiser, Martin R.;Saltz, Leonard B.
通讯作者：
Saltz, Leonard B.