Luo H J, Wang S J, Zhang X F, Tian W Y, Luo W, Dong Z L
Department of Laboratory Center, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Clinical Laboratory, Fengjie County People's Hospital of Chongqing, Chongqing 404600, China.
Zhonghua Yi Xue Za Zhi. 2024 Jun 18;104(23):2167-2172. doi: 10.3760/cma.j.cn112137-20231019-00823.
To establish and validate a prediction model for early-stage epithelial ovarian cancer based on least absolute shrinkage and selection operator (LASSO) regression. A total of 509 cases ovarian mass patients who underwent surgical treatment in Tianjin Medical General Hospital from January 2018 to March 2023 were retrospectively analyzed. The patients were randomly divided into modeling group [=356, (,) for age were 43 (31, 61) years] and internal validation group [=153, age 42 (31, 60) years] by 7∶3 ratio. In addition, 86 patients [age 44 (33, 61) years] who underwent surgical treatment for ovarian mass in Tianjin Medical University General Hospital from April to November 2023 were collected as external validation group. The variables were screened by LASSO regression. The nomogram model was established and plotted by multivariate logistic regression. Internal and external validation were then conducted. The model performance and clinical applicability were evaluated using receiver operating characteristic (ROC) curve, calibration curve and decision curve. Five variables including age (=1.040,:1.000-1.050,=0.002), carbohydrate antigen 125 (CA125) (=1.001, 95%: 1.000-1.010, =0.017), human epididymis protein 4 (HE4) (=1.020, 95%: 1.000-1.030, =0.002), carbohydrate antigen 199 (CA199) (=1.001, 95%:1.000-1.020, =0.023) and lactate dehydrogenase (LDH) (=1.020, 95%: 1.010-1.022, =0.001) were screened as risk factors for early-stage epithelial ovarian cancer. The nomogram model was constructed based on these above five risk factors to predict early-stage epithelial ovarian cancer. ROC curves showed the area under curve (AUC) were 0.915(95%:0.910-0.932)for modeling group, 0.891(95%:0.874-0.905) for internal validation group, and 0.924(95%:0.907-0.942) for external verification. The calibration curves and clinical decision curves showed the model exhibited good consistency and clinical practicability. The nomogram model built includes age, CA125, HE4, CA199, and LDH. It can effectively predict early-stage epithelial ovarian cancer and has strong clinical practicability.
基于最小绝对收缩和选择算子(LASSO)回归建立并验证早期上皮性卵巢癌预测模型。回顾性分析2018年1月至2023年3月在天津医科大学总医院接受手术治疗的509例卵巢肿物患者。患者按7∶3比例随机分为建模组[=356,年龄(中位数,四分位数间距)为43(31,61)岁]和内部验证组[=153,年龄42(31,60)岁]。此外,收集2023年4月至11月在天津医科大学总医院接受卵巢肿物手术治疗的86例患者[年龄44(33,61)岁]作为外部验证组。通过LASSO回归筛选变量。采用多因素逻辑回归建立并绘制列线图模型,随后进行内部和外部验证。使用受试者工作特征(ROC)曲线、校准曲线和决策曲线评估模型性能和临床适用性。年龄(=1.040,95%置信区间:1.000 - 1.050,=0.002)、糖类抗原125(CA125)(=1.001,95%置信区间:1.000 - 1.010,=0.017)、人附睾蛋白4(HE4)(=1.020,95%置信区间:1.000 - 1.030,=0.002)、糖类抗原199(CA199)(=1.001,95%置信区间:1.000 - 1.020,=0.023)和乳酸脱氢酶(LDH)(=1.020,95%置信区间:1.010 - 1.022,=0.001)这五个变量被筛选为早期上皮性卵巢癌的危险因素。基于上述五个危险因素构建列线图模型以预测早期上皮性卵巢癌。ROC曲线显示,建模组曲线下面积(AUC)为0.915(95%置信区间:0.910 - 0.932),内部验证组为0.891(95%置信区间:0.874 - 0.905),外部验证组为0.924(95%置信区间:0.907 - 0.942)。校准曲线和临床决策曲线显示该模型具有良好的一致性和临床实用性。所构建的列线图模型包括年龄、CA125、HE4、CA199和LDH。它能有效预测早期上皮性卵巢癌,具有较强的临床实用性。