Construction and validation of the preoperative nomogram diagnosis model for pancreatic head cancer and distal cholangiocarcinoma
10.3760/cma.j.cn113884-20220514-00212
- VernacularTitle:胰头癌和远端胆管癌术前列线图诊断模型的构建与验证
- Author:
Yanwei WANG
1
;
Chenghao CUI
;
Mingtai LI
;
Yurong LIANG
Author Information
1. 解放军医学院，北京 100853
- Keywords:
Pancreatic neoplasms;
Bile duct neoplasms;
Ampulla of Vater;
Nomograms;
Prediction model
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(12):907-912
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the differences in preoperative examination indexes between pancreatic head cancer and distal bile duct cancer, and to establish a preliminary prediction model to provide reference for clinical decision-making.Methods:Retrospective analysis was conducted on 243 consecutive patients who underwent open radical pancreaticoduodenectomy from January 1, 2015 to December 31, 2019 at the Chinese PLA General Hospital. There were 177 males and 66 females, aged (58.9±8.9) years old. Based on postoperative pathological results, these 243 patients were divided into the pancreatic head cancer group ( n=113) and the distal bile duct cancer group ( n=130). The clinical data of the two groups were collected. Minimum absolute value convergence and selection operator regression were used to screen the best predictors of pancreatic head cancer. The rms package was used to construct the nomogram model, and k-fold cross was used for internal validation. Results:Seven best predictive indexes are selected: age, rate of weight loss, main pancreatic duct diameter, neutrophil/lymphocyte, DTR (DBil/TBil), carcinoembryonic antigen and CA125. Based on these indexes, a nomogram prediction model was constructed with the C-index of 0.868 after k-fold cross-validation, indicating that discrimination of the model to be acceptable. Validation using calibration curve exhibited good concordance between the predicted probability with the ideal probability ( P=0.728). Conclusion:The nomogram prediction model established in this study effectively predicted patients with pancreatic head cancer, and helped preoperatively to differentiate pancreatic head cancer from distal cholangiocarcinoma.
