Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study  

作　　者：Dong Jiang Zi-Xiang Chen Fu-Xiao Ma Yu-Yong Gong Tian Pu Jiang-Ming Chen Xue-Qian Liu Yi-Jun Zhao Kun Xie Hui Hou Cheng Wang Xiao-Ping Geng Fu-Bao Liu 

机构地区：[1]Department of General Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui Province,China [2]Department of General Surgery,The Second Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui Province,China [3]Department of General Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230000,Anhui Province,China

出　　处：《World Journal of Gastroenterology》2022年第37期5469-5482,共14页世界胃肠病学杂志（英文版）

基　　金：University Natural Science Research Project of Anhui Province,No.KJ2021ZD0021.

摘　　要：BACKGROUND Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms(PCNs)are lacking.AIM To establish a nomogram-based online calculator for predicting the risk of malignancy in patients with PCNs.METHODS In this study,the clinicopathological data of target patients in three medical centers were analyzed.The independent sample t-test,Mann–Whitney U test or chi-squared test were used as appropriate for statistical analysis.After univariable and multivariable logistic regression analysis,five independent factors were screened and incorporated to develop a calculator for predicting the risk of malignancy.Finally,the concordance index(C-index),calibration,area under the curve,decision curve analysis and clinical impact curves were used to evaluate the performance of the calculator.RESULTS Enhanced mural nodules[odds ratio(OR):4.314;95%confidence interval(CI):1.618–11.503,P=0.003],tumor diameter≥40 mm(OR:3.514;95%CI:1.138–10.849,P=0.029),main pancreatic duct dilatation(OR:3.267;95%CI:1.230–8.678,P=0.018),preoperative neutrophil-to-lymphocyte ratio≥2.288(OR:2.702;95%CI:1.008–7.244,P=0.048],and preoperative serum CA19-9 concentration≥34 U/mL(OR:3.267;95%CI:1.274–13.007,P=0.018)were independent risk factors for a high risk of malignancy in patients with PCNs.In the training cohort,the nomogram achieved a C-index of 0.824 for predicting the risk of malignancy.The predictive ability of the model was then validated in an external cohort(C-index:0.893).Compared with the risk factors identified in the relevant guidelines,the current model showed better predictive performance and clinical utility.CONCLUSION The calculator demonstrates optimal predictive performance for identifying the risk of malignancy,potentially yielding a personalized method for patient selection and decision-making in clinical practice.

关 键 词：Pancreatic cystic neoplasms Risk of malignancy NOMOGRAM Model PREDICTION CALCULATOR 

分 类 号：R735.9[医药卫生—肿瘤]