Pei Qidong, Chen Junzong, Deng Gang, Li Dong, Tang Yajun, Lai Jiaming, Tang Di
Department of General Surgery, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Department of General Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
BMC Gastroenterol. 2025 Jul 1;25(1):482. doi: 10.1186/s12876-025-04076-7.
Solid pseudopapillary neoplasm of the pancreas (SPN) represents a rare form of low-grade malignant pancreatic cystic neoplasm. This study seeks to construct a predictive nomograph model for SPN recurrence.
Data was collected from patients with SPN from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from the years 2010 to 2021 as the training cohort. We collected data from our two hospitals as an external validation cohort from the years 2011 to 2021. Logistic regression analysis was used to analyze the related factors of recurrence, and a predictive nomograph model was established and verified. The calibration curve was plotted by the Bootstrap method, and the clinical efficacy of the model was evaluated by the decision curve analysis.
The SEER database included 455 patients. Five of them (1.10%) experienced recurrence, and the liver is the main recurrence site. There is a significant difference in tumor size (P = 0.001) between recurrent patients and the non-recurrent. Tumor size (P = 0.012) and regional nodes positive (P = 0.007) were independent predictors of relapse. We constructed a nomograph model based on them, the C-index 0.782 with a p-value 0.001. The C-index of the model in the external validation queue was 0.865 with a p-value 0.009. The calibration curve indicated that the model prediction probability is in well line with the actual observation probability, and decision clinical analysis showed a good net return.
This constructed nomogram could well predict the possibility of SPN recurrence.
胰腺实性假乳头状瘤(SPN)是一种罕见的低度恶性胰腺囊性肿瘤。本研究旨在构建一个预测SPN复发的列线图模型。
收集2010年至2021年美国监测、流行病学和最终结果(SEER)数据库中SPN患者的数据作为训练队列。收集2011年至2021年我们两家医院的数据作为外部验证队列。采用逻辑回归分析复发的相关因素,建立并验证预测列线图模型。采用Bootstrap法绘制校准曲线,通过决策曲线分析评估模型的临床疗效。
SEER数据库包括455例患者。其中5例(1.10%)出现复发,肝脏是主要复发部位。复发患者与未复发患者的肿瘤大小存在显著差异(P = 0.001)。肿瘤大小(P = 0.012)和区域淋巴结阳性(P = 0.007)是复发的独立预测因素。我们基于这些因素构建了一个列线图模型,C指数为0.782,p值为0.001。该模型在外部验证队列中的C指数为0.865,p值为0.009。校准曲线表明模型预测概率与实际观察概率吻合良好,决策临床分析显示有良好的净收益。
构建的该列线图能够很好地预测SPN复发的可能性。