Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China.
Surg Endosc. 2023 Jul;37(7):5453-5463. doi: 10.1007/s00464-023-10056-3. Epub 2023 Apr 11.
Polyp size of 10 mm is insufficient to discriminate neoplastic and non-neoplastic risk in patients with gallbladder polyps (GPs). The aim of the study is to develop a Bayesian network (BN) prediction model to identify neoplastic polyps and create more precise criteria for surgical indications in patients with GPs lager than 10 mm based on preoperative ultrasound features.
A BN prediction model was established and validated based on the independent risk variables using data from 759 patients with GPs who underwent cholecystectomy from January 2015 to August 2022 at 11 tertiary hospitals in China. The area under receiver operating characteristic curves (AUCs) were used to evaluate the predictive ability of the BN model and current guidelines, and Delong test was used to compare the AUCs.
The mean values of polyp cross-sectional area (CSA), long, and short diameter of neoplastic polyps were higher than those of non-neoplastic polyps (P < 0.0001). Independent neoplastic risk factors for GPs included single polyp, polyp CSA ≥ 85 mm , fundus with broad base, and medium echogenicity. The accuracy of the BN model established based on the above independent variables was 81.88% and 82.35% in the training and testing sets, respectively. Delong test also showed that the AUCs of the BN model was better than that of JSHBPS, ESGAR, US-reported, and CCBS in training and testing sets, respectively (P < 0.05).
A Bayesian network model was accurate and practical for predicting neoplastic risk in patients with gallbladder polyps larger than 10 mm based on preoperative ultrasound features.
胆囊息肉(GPs)患者的息肉大小为 10mm 不足以区分肿瘤性和非肿瘤性风险。本研究旨在建立一种贝叶斯网络(BN)预测模型,以识别肿瘤性息肉,并根据术前超声特征为大于 10mm 的 GPs 患者制定更精确的手术指征标准。
本研究基于来自中国 11 家三级医院的 759 例接受胆囊切除术的 GPs 患者的数据,使用独立风险变量建立和验证 BN 预测模型。采用受试者工作特征曲线下面积(AUC)评估 BN 模型和现行指南的预测能力,并采用 Delong 检验比较 AUC。
肿瘤性息肉的息肉横截面积(CSA)、长径和短径的平均值均高于非肿瘤性息肉(P < 0.0001)。GPs 的独立肿瘤危险因素包括单发息肉、息肉 CSA≥85mm、基底宽的基底部和中等回声。基于上述独立变量建立的 BN 模型在训练集和测试集中的准确率分别为 81.88%和 82.35%。Delong 检验还显示,BN 模型在训练集和测试集中的 AUC 均优于 JSHBPS、ESGAR、US 报告和 CCBS(P < 0.05)。
基于术前超声特征,贝叶斯网络模型可准确、实用地预测大于 10mm 的胆囊息肉患者的肿瘤性风险。