前列腺癌手术切缘阳性影像的建立与验证

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.CN112330-20190821-00378

Wanli Cheng, C. Pang, Xinda Song, Chunlong Fu, H. Hou, Liqun Zhou, Lulin Ma, Xu Gao, D. He, Jianye Wang, Ming Liu

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引用次数: 0

摘要

目的建立预测前列腺癌术后切缘阳性的nomogram模型，并进行相应的验证，以预测前列腺癌术后切缘阳性的风险。方法将2015 - 2018年海军医科大学第一附属医院、北京大学附属医院、北京大学附属第一医院、北京大学附属第三医院、北京大学附属第一医院、西安交通大学附属第一医院的前列腺癌患者2 215例纳入PC-follow数据库，采用简单随机抽样方法。模型组1 770例，验证组445例。造模组年龄(70岁)、PSA (20 ng/ml)、盆腔MRI(阴性、可疑、阳性)、肿瘤临床分期(t1 ~ t2、≥T3)、针阳性百分率(≤33%、34% ~ 66%、>66%)、活检病理Gleason评分(≤6分、7分、≥8分)。采用单因素和多因素logistic分析筛选有意义的指标，构建nomogram模型。模型在验证组中进行验证。结果多因素分析结果显示，术前PSA水平(OR=2.046, 95%CI 1.022 ~ 4.251, P=0.009)、穿刺阳性针率(OR=1.502, 95%CI 1.136 ~ 1.978, P=0.002)、穿刺病理Gleason评分(OR=1.568, 95%CI 1.063 ~ 2.313, P=0.028)、盆腔MRI具有相关性(OR=1.525, 95%CI 1.160 ~ 2.005, P=0.033)。建立前列腺癌阳性切缘独立预测因子的nomogram模型。验证组受试者工作特征(ROC)曲线下面积为0.776。术前PSA水平、穿刺阳性针百分比、穿刺病理Gleason评分、盆腔MRI、术后病理Gleason评分的ROC曲线下面积分别为0.554、0.615、0.556、0.522、0.560。nomogram model与其他指标的差异有统计学意义(P<0.05)。结论构建的nomogram模型预测阳性切缘的价值高于术前PSA水平、穿刺阳性针百分比、穿刺病理Gleason评分、盆腔MRI及术后病理Gleason评分。关键词:前列腺肿瘤;前列腺癌;阳性切缘;模型的统计

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Establishment and validation of nomogram for positive surgical margin of prostate cancer

Objective To establish a nomogram model for predicting positive resection margins after prostate cancer surgery, and to perform the corresponding verification, in order to predict the risk of positive resection margins after surgery. Methods A total of 2 215 prostate cancer patients from The First Affiliated Hospital of Naval Medical University, Hospital, Peking University First Hospital, Peking University Third Hospital, Peking University, and First Affiliated Hospital of Xi′an Jiaotong University were included in the PC-follow database from 2015 to 2018, and a simple random sampling method was used. They were divided into 1 770 patients in the modeling group and 445 patients in the verification group. In the modeling group, the age ( 70 years), PSA ( 20 ng/ml), pelvic MRI (negative, suspicious, positive), clinical stage of the tumor (T1-T2, ≥T3), percentage of positive needles (≤33%, 34%-66%, >66%), Gleason score of biopsy pathology (≤6 points, 7 points, ≥8 points). Univariate and multivariate logistic analysis were performed to screen meaningful indicators to construct a nomogram model. The model was used for validation in the validation group. Results The results of multivariate analysis showed that preoperative PSA level (OR=2.046, 95%CI 1.022 to 4.251, P=0.009), percentage of puncture positive needles (OR=1.502, 95%CI 1.136 to 1.978, P=0.002), Gleason score of puncture pathology (OR=1.568, 95%CI 1.063 to 2.313, P=0.028), pelvic MRI were correlated (OR=1.525, 95%CI 1.160 to 2.005, P=0.033). Establish a nomogram model for independent predictors of positive margin of prostate cancer. The area under the receiver operating characteristic (ROC) curve of the validation group is 0.776. The area under the ROC curve of the preoperative PSA level, percentage of puncture positive needles, puncture pathology Gleason score, pelvic MRI, postoperative pathology Gleason score were 0.554, 0.615, 0.556, 0.522, and 0.560, respectively. The difference between the nomogram model and other indicators was statistically significant (P<0.05). Conclusions The constructed nomogram model has higher diagnostic value than the preoperative PSA level, percentage of puncture positive needles, Gleason score of puncturing pathology, pelvic MRI, and postoperative pathological Gleason score in predicting positive margin. Key words: Prostatic neoplasms; Prostate cancer; Positive surgical margin; Models statistical

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.