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提高精准医学水平:上皮性卵巢癌铂耐药预测列线图。

Enhancing precision medicine: a nomogram for predicting platinum resistance in epithelial ovarian cancer.

机构信息

Department of Gynecology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.

Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.

出版信息

World J Surg Oncol. 2024 Mar 21;22(1):81. doi: 10.1186/s12957-024-03359-9.

Abstract

BACKGROUND

This study aimed to develop a novel nomogram that can accurately estimate platinum resistance to enhance precision medicine in epithelial ovarian cancer(EOC).

METHODS

EOC patients who received primary therapy at the General Hospital of Ningxia Medical University between January 31, 2019, and June 30, 2021 were included. The LASSO analysis was utilized to screen the variables which contained clinical features and platinum-resistance gene immunohistochemistry scores. A nomogram was created after the logistic regression analysis to develop the prediction model. The consistency index (C-index), calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to assess the nomogram's performance.

RESULTS

The logistic regression analysis created a prediction model based on 11 factors filtered down by LASSO regression. As predictors, the immunohistochemical scores of CXLC1, CXCL2, IL6, ABCC1, LRP, BCL2, vascular tumor thrombus, ascites cancer cells, maximum tumor diameter, neoadjuvant chemotherapy, and HE4 were employed. The C-index of the nomogram was found to be 0.975. The nomogram's specificity is 95.35% and its sensitivity, with a cut-off value of 165.6, is 92.59%, as seen by the ROC curve. After the nomogram was externally validated in the test cohort, the coincidence rate was determined to be 84%, and the ROC curve indicated that the nomogram's AUC was 0.949.

CONCLUSION

A nomogram containing clinical characteristics and platinum gene IHC scores was developed and validated to predict the risk of EOC platinum resistance.

摘要

背景

本研究旨在开发一种新的列线图,以准确评估铂类耐药,从而增强上皮性卵巢癌(EOC)精准医学的水平。

方法

纳入 2019 年 1 月 31 日至 2021 年 6 月 30 日在宁夏医科大学总医院接受初次治疗的 EOC 患者。采用 LASSO 分析筛选包含临床特征和铂类耐药基因免疫组化评分的变量。通过逻辑回归分析建立预测模型,生成列线图。采用一致性指数(C 指数)、校准曲线、受试者工作特征(ROC)曲线和决策曲线分析(DCA)评估列线图的性能。

结果

逻辑回归分析基于 LASSO 回归筛选出的 11 个因素构建了预测模型。作为预测因子,采用免疫组化评分的 CXLC1、CXCL2、IL6、ABCC1、LRP、BCL2、血管肿瘤栓子、腹水癌细胞、最大肿瘤直径、新辅助化疗和 HE4。列线图的 C 指数为 0.975。ROC 曲线显示,列线图的特异性为 95.35%,截断值为 165.6 时,敏感性为 92.59%。在测试队列中对列线图进行外部验证后,其符合率为 84%,ROC 曲线表明列线图的 AUC 为 0.949。

结论

开发并验证了一种包含临床特征和铂类基因免疫组化评分的列线图,用于预测 EOC 铂类耐药的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/529b/10956367/5a3cb96ced1c/12957_2024_3359_Fig1_HTML.jpg

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