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基于人群的研究:一种预测初诊甲状腺癌患者发生骨转移风险的新型列线图。

Novel nomogram to predict risk of bone metastasis in newly diagnosed thyroid carcinoma: a population-based study.

机构信息

Department of Orthopedic, Affiliated Hospital of Chengde Medical University, No. 36 Nanyingzi St, Chengde, 067000, Hebei, China.

Qingdao University Medical College, Qingdao, 266000, Shandong, China.

出版信息

BMC Cancer. 2020 Nov 3;20(1):1055. doi: 10.1186/s12885-020-07554-1.

Abstract

BACKGROUND

The aim of this study was to develop and validate a visual nomogram for predicting the risk of bone metastasis (BM) in newly diagnosed thyroid carcinoma (TC) patients.

METHODS

The demographics and clinicopathologic variables of TC patients from 2010 to 2015 in the Surveillance, Epidemiology and End Results (SEER) database were retrospectively reviewed. Chi-squared (χ2) test and logistic regression analysis were performed to identify independent risk factors. Based on that, a predictive nomogram was developed and validated for predicting the risk of BM in TC patients. The C-index was used to compute the predictive performance of the nomogram. Calibration curves and decision curve analysis (DCA) were furthermore used to evaluate the clinical value of the nomogram.

RESULTS

According to the inclusion and exclusion criteria, the data of 14,772 patients were used to analyze in our study. After statistical analysis, TC patients with older age, higher T stage, higher N stage, poorly differentiated, follicular thyroid carcinoma (FTC) and black people had a higher risk of BM. We further developed a nomogram with a C-index of 0.925 (95%CI,0.895-0.948) in the training set and 0.842 (95%CI,0.777-0.907) in the validation set. The calibration curves and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model.

CONCLUSIONS

The present study developed a visual nomogram to accurately identify TC patients with high risk of BM, which might help to further provide more individualized clinical decision guidelines.

摘要

背景

本研究旨在开发和验证一种用于预测新诊断甲状腺癌(TC)患者发生骨转移(BM)风险的可视化列线图。

方法

回顾性分析 2010 年至 2015 年 SEER 数据库中 TC 患者的人口统计学和临床病理变量。采用卡方(χ2)检验和逻辑回归分析确定独立的危险因素。在此基础上,建立并验证了预测 TC 患者发生 BM 风险的列线图。采用 C 指数评估列线图的预测性能。进一步绘制校准曲线和决策曲线分析(DCA)评估列线图的临床价值。

结果

根据纳入和排除标准,本研究共纳入 14772 例患者的数据进行分析。经统计学分析,年龄较大、T 分期较高、N 分期较高、低分化、滤泡状甲状腺癌(FTC)和黑人的 TC 患者发生 BM 的风险更高。我们进一步开发了一个 C 指数为 0.925(95%CI,0.895-0.948)的列线图,在训练集中的 C 指数为 0.842(95%CI,0.777-0.907)。校准曲线和决策曲线分析(DCA)也表明了该临床预测模型的可靠性和准确性。

结论

本研究开发了一种可视化列线图,可以准确识别发生 BM 风险较高的 TC 患者,这可能有助于进一步提供更个体化的临床决策指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2250/7607856/2a1ec4734bbb/12885_2020_7554_Fig1_HTML.jpg

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