围绝经期子宫内膜异位症恶变风险预测列线图的建立  

Establishment of a Nomogram for predicting risk of malignant transformation of perimenopausal endometriosis

作　　者：王媛媛[1] 李颖颖 常丰华 高雅 李艳芹 李梦梦 封全灵[1] WANG Yuanyuan;LI Yingying;CHANG Fenghua;GAO Ya;LI Yanqin;LI Mengmeng;FENG Quanling(Department of Gynecology,the Third Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Gynecology,Henan Provincial People′s Hospital,Zhengzhou 450003;Department of Internal Medicine,Henan Cancer Hospital,Zhengzhou 450003)

机构地区：[1]郑州大学第三附属医院妇科,郑州450052 [2]河南省人民医院妇科,郑州450003 [3]河南省肿瘤医院内科,郑州450003

出　　处：《郑州大学学报（医学版）》2023年第3期394-398,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省高等学校重点科研项目(20B320055)。

摘　　要：目的:建立预测围绝经期子宫内膜异位症(EMT)患者恶变风险的列线图并对该模型进行评估。方法:收集处于围绝经期的370例EMT及42例EMT相关性卵巢癌患者的临床资料,在建模集中采用Logistic回归筛选预测变量,绘制列线图并进行评估。结果:绝经状态、进行性痛经、更年期单雌激素应用史、不孕及卵巢型EMT是围绝经期EMT发生恶变的危险因素,OR(95%CI)分别为4.675(1.399~15.623)、5.270(1.401~19.822)、3.576(1.280~9.987)、9.302(2.139~40.445)、7.653(1.775~32.999)。基于Logistic回归分析结果绘制列线图,其在建模集及验证集中预测的ROC曲线AUC(95%CI)分别为0.856(0.829~0.882)、0.892(0.850~0.934),预测能力良好。校正曲线分析结果显示,该列线图预测建模集、验证集中围绝经期EMT患者恶变发生率与实际发生率相吻合。结论:该列线图对围绝经期EMT恶变高危人群有较好的筛选能力。Aim:To construct a predictive model for malignant risk of endometriosis in perimenopausal women and evaluate the model.Methods:A total of 370 patients with perimenopausal endometriosis and 42 patients with endometriosis-associated ovarian cancer were selected.Logistic regression was used in the modeling set to screen out the predictive variables,and the Nomogram model was drawn and evaluated.Results:Menopausal status,progressive dysmenorrhea,single estrogen application history in menopause,infertility and ovarian endometriosis were risk factors for malignant transformation of perimenopausal endometriosis,and OR(95%CI)were 4.675(1.399-15.623),5.270(1.401-19.822),3.576(1.280-9.987),9.302(2.139-40.445),7.653(1.775-32.999).Based on the results of Logistic regression analysis,a Nomogram was drawn,and its AUC(95%CI)of modeling set and test set were 0.856(0.829-0.882),0.892(0.850-0.934),respectively.The calibration curve showed good predictive ability.The calibration curve analysis showed that the incidence of malignant transformation of perimenopausal endometriosis patients in the modeling set and test set predicted by the Nomogram was consistent with the actual incidence.Conclusion:The Nomogram has a good screening ability for the high-risk population with endometriosis in perimenopausal period.

关 键 词：子宫内膜异位症 恶变 围绝经期 列线图 

分 类 号：R737.31[医药卫生—肿瘤]