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Development and Validation of a Nomogram for Early Detection of Malignant Gallbladder Lesions.

発表形態:
原著論文
主要業績:
主要業績
単著・共著:
共著
発表年月:
2019年10月
DOI:
10.14309/ctg.0000000000000098
会議属性:
指定なし
査読:
有り
リンク情報:

日本語フィールド

著者:
*Chen M, Cao J, Bai Y, Tong C, Lin J, Jindal V, Barchi LC, Nadalin S, Yang SX, Pesce A, Panaro F, Ariche A, Kai K, Memeo R, Bekaii-Saab T, Cai X
題名:
Development and Validation of a Nomogram for Early Detection of Malignant Gallbladder Lesions.
発表情報:
Clin Transl Gastroenterol. 巻: 10 号: 10 ページ: e00098
キーワード:
概要:
Objectives: Preoperative decision-making for differentiating malignant from benign lesions in the gallbladder remains challenging. We aimed to create a diagnostic nomogram to identify gallbladder cancer (GBC), especially for incidental GBC (IGBC), before surgical resection. Methods: A total of 587 consecutive patients with pathologically confirmed gallbladder lesions from a hospital were randomly assigned to a training cohort (70%) and an internal validation cohort (30%), with 287 patients from other centers as an external validation cohort. Radiological features were developed by the least absolute shrinkage and selection operator logistic regression model. Significant radiological features and independent clinical factors, identified by multivariate analyses, were used to construct a nomogram. Results: A diagnostic nomogram was established by age, CA19.9, and 6 radiological features. The values of area under the curve in the internal and external validation cohorts were up to 0.91 and 0.89, respectively. The calibration curves for probability of GBC showed optimal agreement between nomogram prediction and actual observation. Compared with previous methods, it demonstrated superior sensitivity (91.5%) and accuracy (85.1%) in the diagnosis of GBC. The accuracy using the nomogram was significantly higher in GBC groups compared with that by radiologists in the training cohort (P < 0.001) and similarly in each cohort. Notably, most of the IGBC, which were misdiagnosed as benign lesions, were successfully identified using this nomogram. Discussion: A novel nomogram provides a powerful tool for detecting the presence of cancer in gallbladder masses, with an increase in accuracy and sensitivity. It demonstrates an unprecedented potential for IGBC identification.
抄録:

英語フィールド

Author:
*Chen M, Cao J, Bai Y, Tong C, Lin J, Jindal V, Barchi LC, Nadalin S, Yang SX, Pesce A, Panaro F, Ariche A, Kai K, Memeo R, Bekaii-Saab T, Cai X
Title:
Development and Validation of a Nomogram for Early Detection of Malignant Gallbladder Lesions.
Announcement information:
Clin Transl Gastroenterol. Vol: 10 Issue: 10 Page: e00098
An abstract:
Objectives: Preoperative decision-making for differentiating malignant from benign lesions in the gallbladder remains challenging. We aimed to create a diagnostic nomogram to identify gallbladder cancer (GBC), especially for incidental GBC (IGBC), before surgical resection. Methods: A total of 587 consecutive patients with pathologically confirmed gallbladder lesions from a hospital were randomly assigned to a training cohort (70%) and an internal validation cohort (30%), with 287 patients from other centers as an external validation cohort. Radiological features were developed by the least absolute shrinkage and selection operator logistic regression model. Significant radiological features and independent clinical factors, identified by multivariate analyses, were used to construct a nomogram. Results: A diagnostic nomogram was established by age, CA19.9, and 6 radiological features. The values of area under the curve in the internal and external validation cohorts were up to 0.91 and 0.89, respectively. The calibration curves for probability of GBC showed optimal agreement between nomogram prediction and actual observation. Compared with previous methods, it demonstrated superior sensitivity (91.5%) and accuracy (85.1%) in the diagnosis of GBC. The accuracy using the nomogram was significantly higher in GBC groups compared with that by radiologists in the training cohort (P < 0.001) and similarly in each cohort. Notably, most of the IGBC, which were misdiagnosed as benign lesions, were successfully identified using this nomogram. Discussion: A novel nomogram provides a powerful tool for detecting the presence of cancer in gallbladder masses, with an increase in accuracy and sensitivity. It demonstrates an unprecedented potential for IGBC identification.


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