Development and external validation of a quantitative diagnostic model for malignant gastric lesions in clinical opportunistic screening: A multicenter real-world study
10.1097/CM9.0000000000002903
- VernacularTitle:Development and external validation of a quantitative diagnostic model for malignant gastric lesions in clinical opportunistic screening: A multicenter real-world study
- Author:
Hongchen ZHENG
1
,
2
;
Zhen LIU
;
Yun CHEN
;
Ping JI
;
Zhengyu FANG
;
Yujie HE
;
Chuanhai GUO
;
Ping XIAO
;
Chengwen WANG
;
Weihua YIN
;
Fenglei LI
;
Xiujian CHEN
;
Mengfei LIU
;
Yaqi PAN
;
Fangfang LIU
;
Ying LIU
;
Zhonghu HE
;
Yang KE
Author Information
1. State Key Laboratory of Molecular Oncology, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Genetics, Peking University Cancer Hospital &
2. Institute, Beijing 100142, China
- Keywords:
Early detection of cancer;
Cancer early diagnosis;
Gastric cancer;
Diagnostic model;
Opportunistic screening;
Feeding behavior;
Weight loss;
Sex characterist
- From:
Chinese Medical Journal
2024;137(19):2343-2350
- CountryChina
- Language:Chinese
-
Abstract:
Background::Clinical opportunistic screening is a cost-effective cancer screening modality. This study aimed to establish an easy-to-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods::We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China. The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics. The final model was derived based on unconditional logistic regression, and predictors were selected according to the Akaike information criterion. External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results::This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors, including advanced age, male gender, family history of gastric cancer, low body mass index, unexplained weight loss, consumption of leftover food, consumption of preserved food, and epigastric pain. This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve (AUC) of 0.791 (95% confidence interval [CI]: 0.750–0.831). External validation of the model in the general population generated an AUC of 0.696 (95% CI: 0.570–0.822). This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion::This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.
