Timmer Ferdinand C A, Artz Janneke C J M, Beynon Andy J, Donders Rogier T, Mulder Jef J S, Cremers Cor W R J, Graamans Kees
Donders Institute for Brain, Cognition, and Behavior, Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Ann Otol Rhinol Laryngol. 2011 Dec;120(12):807-13. doi: 10.1177/000348941112001206.
The aim of this study was to formulate a predictive rule for vestibular schwannoma growth during the initial observation period after diagnosis.
Logistic regression models were fitted, with tumor growth in the first year as the dependent variable and patient characteristics as the independent variables. Backward selection was used to eliminate superfluous predictors. The area under the receiver operating characteristic curve was taken as a measure of the model's discriminative power.
Eventually, the model or rule consisted of 4 significant growth predictors: localization (if extrameatal, +1; if intrameatal, 0), sudden sensorineural hearing loss (if present, -1; if absent, 0), balance symptoms (if present, +1; if absent, 0), and complaints of hearing loss for less than 2 years (if present, +1; if absent, or present for more than 2 years, 0). A higher score indicates a higher likelihood of tumor growth during the period of observation after diagnosis. If the total score is 0 or less, the likelihood of tumor growth during the first year after diagnosis is less than 10%. If the score is 3, the likelihood of growth during the first year after diagnosis is more than 70%.
We were able to create a useful rule to predict vestibular schwannoma growth during the first year after diagnosis.
本研究的目的是制定一个关于前庭神经鞘瘤在诊断后初始观察期内生长情况的预测规则。
构建逻辑回归模型，将第一年的肿瘤生长情况作为因变量，患者特征作为自变量。采用向后选择法剔除多余的预测变量。将受试者工作特征曲线下的面积作为模型判别能力的指标。
最终，该模型或规则由4个显著的生长预测因素组成：肿瘤位置（如果位于外耳道外，计+1；如果位于外耳道内，计0）、突发感音神经性听力损失（如果存在，计-1；如果不存在，计0）、平衡症状（如果存在，计+1；如果不存在，计0）以及听力损失主诉少于2年（如果存在，计+1；如果不存在或存在超过2年，计0）。分数越高表明诊断后观察期内肿瘤生长的可能性越大。如果总分等于或小于0，诊断后第一年肿瘤生长的可能性小于10%。如果分数为3，诊断后第一年生长的可能性超过70%。
我们能够创建一个有用的规则来预测前庭神经鞘瘤在诊断后第一年的生长情况。
