Zhang Kun, Dai Longguo, Wang Huijian, Xu Shiyi, Cheng Xianli, Wang Yang, Jiang Haiyang, Zhang Chongjian, Zhu Bingyu, Shi Yuanlong, Bai Yu
Urology Medical Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Yunnan, China.
School of Finance, Yunnan University of Finance and Economics, Yunnan, China.
Transl Androl Urol. 2024 Aug 31;13(8):1436-1445. doi: 10.21037/tau-24-145. Epub 2024 Aug 26.
Penile squamous cell carcinoma is a relatively rare malignancy among male malignancies, there are more than 30,000 new cases and more than 10,000 deaths of penile cancer annually. In patients with penile malignancy, inguinal lymph node metastasis (ILNM) significantly reduces patient survival. Thus, we identified the risk factors for ILNM in penile malignancies, aiming to develop a precise prediction model.
We retrospectively analyzed 112 male patients with penile cancer. All subjects underwent penile surgery and inguinal lymphadenectomy at the same time, and postoperative pathology confirmed ILNM. Fisher's exact test, -test, and Wilcoxon rank sum test were used to assess differences in demographic information and clinical features between the two groups, followed by logical least absolute shrinkage and selection operator (LASSO) regression analysis to determine risk factors of ILNM. The prediction model was constructed using nomogram.
LASSO regression revealed that age [β=-0.005, odds ratio (OR) =0.995], smoking history (β=-0.006, OR =0.994) and interleukin 2 (IL-2) level (β=-0.0112, OR =0.989) were protective against ILNM. However, lymph node diameter (β=0.3117, OR =1.366), T-stage (β=0.1254, OR =1.134), fibrinogen (β=0.0377, OR =1.038), IL-4 level (β=0.004, OR =1.001), and neutrophil-to-lymphocyte ratio (β=0.0355, OR =1.034) were risk factors for developing ILNM. When assessing the risk of metastasis, it is crucial to balance these factors. The aforementioned characteristics were utilized to establish the predictive model, which demonstrated a good predictive ability with an area under the curve (AUC) value of 0.81. Moreover, internal leave-one-way cross-validation was used to construct a nomogram showing consistency, with an AUC of 0.75.
The diagnosis of ILNM in penile malignant tumors can be predicted through clinicopathological features, biochemical tests, and prediction models based on tumor markers.
阴茎鳞状细胞癌在男性恶性肿瘤中是一种相对罕见的恶性肿瘤，每年有超过30000例阴茎癌新发病例和超过10000例死亡病例。在阴茎恶性肿瘤患者中，腹股沟淋巴结转移（ILNM）显著降低患者生存率。因此，我们确定了阴茎恶性肿瘤中ILNM的危险因素，旨在建立一个精确的预测模型。
我们回顾性分析了112例阴茎癌男性患者。所有受试者均同时接受了阴茎手术和腹股沟淋巴结清扫术，术后病理证实为ILNM。采用Fisher精确检验、t检验和Wilcoxon秩和检验评估两组患者的人口统计学信息和临床特征差异，随后进行逻辑最小绝对收缩和选择算子（LASSO）回归分析以确定ILNM的危险因素。使用列线图构建预测模型。
LASSO回归显示年龄[β=-0.005，比值比（OR）=0.995]、吸烟史（β=-0.006，OR =0.994）和白细胞介素2（IL-2）水平（β=-0.0112，OR =0.989）对ILNM有保护作用。然而，淋巴结直径（β=0.3117，OR =1.366）、T分期（β=0.1254，OR =1.134）、纤维蛋白原（β=0.0377，OR =1.038）、IL-4水平（β=0.004，OR =1.001）和中性粒细胞与淋巴细胞比值（β=0.0355，OR =1.034）是发生ILNM的危险因素。在评估转移风险时，平衡这些因素至关重要。利用上述特征建立了预测模型，其曲线下面积（AUC）值为0.81，显示出良好的预测能力。此外，采用内部留一法交叉验证构建了一致性良好的列线图，AUC为0.75。
阴茎恶性肿瘤中ILNM的诊断可通过临床病理特征、生化检查以及基于肿瘤标志物的预测模型进行预测。
