Risk factors for predicting early papillary gastric adenocarcinoma and construc-tion of a diagnostic nomogram
10.13315/j.cnki.cjcep.2025.07.002
- VernacularTitle:预测早期乳头状胃腺癌发生的危险因素与列线图诊断模型的构建
- Author:
Jiaqi CHEN
1
;
Mulan JIN
;
Chengjun ZHOU
Author Information
1. 首都医科大学附属北京朝阳医院病理科,北京 100020
- Publication Type:Journal Article
- Keywords:
gastric neoplasms;
early papillary gastric adenocarcinoma;
clinicopathological characteristics;
risk fac-tors;
nomogram;
MUC5AC;
microsatellite instability
- From:
Chinese Journal of Clinical and Experimental Pathology
2025;41(7):844-852
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the independent risk factors for early papillary gastric adenocarcinoma(EP-GA)and construct a diagnostic nomogram.Methods A retrospective analysis was performed on the clinicopathologi-cal characteristics of 325 cases of early differentiated gastric adenocarcinoma.Taking EPGA as the case group and early well-moderately differentiated tubular gastric adenocarcinoma(ETGA)as the control group,the independent risk fac-tors for the occurrence of EPGA were identified through univariate and multivariate analyses,and a nomogram was con-structed.The diagnostic performance of the nomogram was evaluated using the receiver operating characteristic(ROC)curves,Hosmer-Lemeshow goodness-of-fit tests,and calibration curves.Results Among the 325 cases of early differ-entiated gastric adenocarcinoma,there were 121 cases of EPGA and 204 cases of ETGA.Univariate analysis showed that elevated appearance(56.3％),ulcer formation(11.5％),tumor maximum diameter of 2.15(1.60,3.00)cm,moderately-differentiated(55.2％),submucosal invasion(21.9％),lymphovascular invasion(10.4％),high ex-pression of MUC5AC(75.0％),microsatellite instability-high(15.6％),and wild-type expression of p53(59.4％)were significantly associated with an increased risk of EPGA.Multivariate analysis revealed that gross appearance,ul-cer formation,tumor maximum diameter,and the expression of MUC5AC was independent risk factors for EPGA.A di-agnostic nomogram was constructed,and the area under the ROC curve(AUC)was calculated.In the training and val-idation cohorts,the AUC values were 0.847(95％CI=0.799-0.896)and 0.830(95％CI=0.733-0.927),re-spectively.The Hosmer-Lemeshow goodness-of-fit tests showed that x2=13.498,P=0.096,and x2=7.138,P=0.415,respectively.Conclusion The nomogram,based on independent risk factors,exhibits good accuracy for diag-nosing EPGA and can help pathologists in achieving rapid and precise EPGA diagnosis.
