用于预测胆囊切除术患者偶然胆囊癌的风险评分模型。

A risk score model to predict incidental gallbladder cancer in patients scheduled for cholecystectomy.

机构信息

Department of Clinical Sciences Lund, Surgery, Lund University and Skane University Hospital, Lund, Sweden.

Department of Clinical Sciences Lund, Cardiothoracic surgery, Lund University and Skane University Hospital, Lund, Sweden.

出版信息

Am J Surg. 2020 Sep;220(3):741-744. doi: 10.1016/j.amjsurg.2020.01.039. Epub 2020 Jan 24.

DOI:10.1016/j.amjsurg.2020.01.039

PMID:32037044

Abstract

BACKGROUND

Gallbladder cancer (GBC) has a poor prognosis. The aim was to develop and validate a preoperative risk score for incidental gallbladder cancer (IGBC) in patients scheduled for cholecystectomy.

METHODS

Data registered in the nationwide Swedish Registry for Gallstone Surgery (GallRiks) was analyzed, including the derivation cohort (n = 28915, 2007-2014) and the validation cohort (n = 7851, 2014-2016). An additive risk score model based on odds ratio was created.

RESULTS

The scoring model to predict IGBC includes age, female gender, previous cholecystitis, and either jaundice or acute cholecystitis. The calibration by HL test and discrimination by AUROC was 8.27 (P = 0.291) and 0.76 in the derivation cohort (214 IGBC) and 14.28 (P = 0.027) and 0.79 in the validation cohort (35 IGBC). The scoring system was applied to three risk-groups, based on the risk of having IGBC, eg. the high-risk group (>8 points) included 7878 patients, with 154 observed and 148 expected IGBC cases.

CONCLUSION

We present the first risk score model to predict IGBC. The model estimates the expected risk for the individual patient and may help to optimize treatment strategies.

摘要

背景

胆囊癌（GBC）预后较差。本研究旨在开发和验证一种用于胆囊切除术患者偶然胆囊癌（IGBC）的术前风险评分。

方法

分析了全国性胆石症手术登记处（GallRiks）注册的数据，包括推导队列（n=28915，2007-2014 年）和验证队列（n=7851，2014-2016 年）。创建了基于优势比的加性风险评分模型。

结果

预测 IGBC 的评分模型包括年龄、女性、既往胆囊炎、黄疸或急性胆囊炎。HL 检验的校准和 AUROC 的区分度在推导队列（214 例 IGBC）中分别为 8.27（P=0.291）和 0.76，在验证队列（35 例 IGBC）中分别为 14.28（P=0.027）和 0.79。该评分系统基于发生 IGBC 的风险将患者分为三个风险组，例如高风险组（>8 分）包括 7878 例患者，观察到 154 例和预期 148 例 IGBC 病例。