在3家大型医疗中心的180例接受胰腺切除术的患者中，验证用于预测导管内乳头状黏液性肿瘤患者发生癌变概率的列线图。
Validation of a nomogram for predicting the probability of carcinoma in patients with intraductal papillary mucinous neoplasm in 180 pancreatic resection patients at 3 high-volume centers.
作者信息
Shimizu Yasuhiro, Yamaue Hiroki, Maguchi Hiroyuki, Yamao Kenji, Hirono Seiko, Osanai Manabu, Hijioka Susumu, Kanemitsu Yukihide, Sano Tsuyoshi, Senda Yoshiki, Bhatia Vikram, Yanagisawa Akio
机构信息
From the *Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya; †Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama; ‡Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo; §Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya; ∥Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan; ¶Department of Medical Hepatology, Institute of Liver and Biliary Sciences, Delhi, India; and #Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
出版信息
Pancreas. 2015 Apr;44(3):459-64. doi: 10.1097/MPA.0000000000000269.
OBJECTIVE
We previously published a nomogram for prediction of carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). The objective of the current study was to validate this nomogram in an external cohort of patients at multiple institutions.
METHODS
The clinical details of 180 patients with IPMN who underwent a pancreatic resection at 3 hospitals were collected. Four significant predictive factors (sex, lesion type, nodule height, and pancreatic juice cytology) were analyzed.
RESULTS
Of the 180 patients, 66 (36.7%) had a main pancreatic duct-type IPMN and 114 (63.3%) had a branch pancreatic duct-type IPMN. The final pathological diagnosis was benign IPMN in 95 (52.8%) patients and malignant IPMN in 85 (47.2%) patients. The area under the receiver operating characteristic curve for the model was 0.760. The area under the receiver operating characteristic curve of the IPMN nomogram for prediction of malignancy was 0.747 in main pancreatic duct-type IPMN and 0.752 in branch pancreatic duct-type IPMN. The sensitivity and specificity of the model were 80.0% and 57.9%, respectively, when the predictive probability of more than 10% was used to indicate the presence of carcinoma.
CONCLUSIONS
This nomogram for predicting the probability of carcinoma in patients with IPMN was accurate in an external validation patient cohort.
目的
我们之前发表了一种用于预测导管内乳头状黏液性肿瘤（IPMN）患者发生癌变的列线图。本研究的目的是在多个机构的外部患者队列中验证该列线图。
方法
收集了在3家医院接受胰腺切除术的180例IPMN患者的临床详细信息。分析了4个重要的预测因素（性别、病变类型、结节高度和胰液细胞学）。
结果
180例患者中，66例（36.7%）为胰管主干型IPMN，114例（63.3%）为分支胰管型IPMN。最终病理诊断为良性IPMN的患者有95例（52.8%），恶性IPMN的患者有85例（47.2%）。该模型的受试者工作特征曲线下面积为0.760。预测恶性肿瘤的IPMN列线图在胰管主干型IPMN中的受试者工作特征曲线下面积为0.747，在分支胰管型IPMN中为0.752。当使用超过10%的预测概率来表明存在癌变时，该模型的敏感性和特异性分别为80.0%和57.9%。
结论
这种用于预测IPMN患者癌变概率的列线图在外部验证患者队列中是准确的。
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