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| 1 | A nomogramfor predicting overall survival in patients with low-grade endometrial stromal sarcoma: A population-based analysis显示文摘Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance,Epidemiology and End Results(SEER)database.They were further divided into a training cohort and a validation cohort.The Akaike information criterion was used to select variables for the nomogram.The discrimination and calibration of the nomogram were evaluated using concordance index(C-index),area under time-dependent receiver operating characteristic curve(time-dependent AUC),and calibration plots.The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics(FIGO)criteria-based tumor staging using decision curve analysis(DCA).Net reclassification index(NRI)and integrated discrimination improvement(IDI)were also used to compare the nomogram’s clinical utilitywith that of the FIGO criteria-based tumor staging.The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.Results:Seven variables were selected to establish the nomogram for LG-ESS.The C-index(0.814 for the training cohort and 0.837 for the validation cohort)and the time-dependent AUC(>0.7)indicated satisfactory discriminative ability of the nomogram.The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts.The NRI values(training cohort:0.271 for 5-year and 0.433 for 10-year OS prediction;validation cohort:0.310 for 5-year and 0.383 for 10-year OS prediction)and IDI(training cohort:0.146 for 5-year and 0.185 for 10-year OS prediction;validation cohort:0.177 for 5-year and 0.191 for 10-year OS prediction)indicated that the established nomogram performed significantly better than the FIGO criteria-based tumor staging alone(P<0.05).Furthermore,DCA showed that the nomogram was clinically useful and had better discriminative ability to recognize patients at high risk than the FIGO criteria-based tumor staging.Conclusions:A prognostic nomogram was developed and validated to assist clinicians in evaluating prognosis of LG-ESS patients. | Jie Wu Huibo Zhang Lan Li Mengxue Hu Liang Chen Bin Xu Qibin Song | 2020 | Cancer Communications2020，40，7： | 35 |
| 2 | Nomogram to predict overall survival after gallbladder cancer resection in China显示文摘AIM To integrate clinically significant variables related to prognosis after curative resection for gallbladder carcinoma(GBC) into a predictive nomogram.METHODS One hundred and forty-two GBC patients who underwent curative intent surgical resection at Peking Union Medical College Hospital(PUMCH) were included. This retrospective case study was conducted at PUMCH of the Chinese Academy of Medical Sciences and Peking Union Medical College(CAMS & PUMC) in China from January 1, 2003 to January 1, 2018. The continuous variable carbohydrate antigen 19-9(CA19-9) was converted into a categorical variable(cCA19-9) based on the normal reference range. Stages 0 to IIIA were merged into one category, while the remaining stages were grouped into another category. Pathological grade X(GX) was treated as a missing value. A multivariate Cox proportional hazards model was used to select variables to construct a nomogram. Discrimination and calibration of the nomogram were performed via the concordance index(C-index) and calibration plots. The performance of the nomogram was estimated using the calibration curve. Receiver operating characteristic(ROC) curve analysis and decision curve analysis(DCA) were performed to evaluate the predictive accuracy and net benefit of the nomogram, respectively.RESULTS Of these 142 GBC patients, 55(38.7%) were male, and the median and mean age were 64 and 63.9 years, respectively. Forty-eight(33.8%) patients in this cohort were censored in the survival analysis. The median survival time was 20 months. A series of methods, including the likelihood ratio test and Akaike information criterion(AIC) as well as stepwise, forward, and backward analyses, were used to select the model, and all yielded identical results. Jaundice [hazard ratio(HR) = 2.9; 95% confidence interval(CI): 1.60-5.27], cCA19-9(HR = 3.2; 95%CI: 1.91-5.39), stage(HR = 1.89; 95%CI: 1.16-3.09), and resection(R)(HR = 2.82; 95%CI: 1.54-5.16) were selected as significant predictors and combined into a survival time predictive nomogram(C-index = 0.803; 95%CI: 0.766-0.839). High prediction accuracy(adjusted C-index = 0.797) was further verified via bootstrap validation. The calibration plot demonstrated good performance of the nomogram. ROC curve analysis revealed a high sensitivity and specificity. A high net benefit was proven by DCA.CONCLUSION A nomogram has been constructed to predict the overall survival of GBC patients who underwent radical surgery from a clinical database of GBC at PUMCH. | Yi Bai Zhi-Song Liu Jian-Ping Xiong Wei-Yu Xu Jian-Zhen Lin Jun-Yu Long Fei Miao Han-Chun Huang Xue-Shuai Wan Hai-Tao Zhao | 2018 | World Journal of Gastroenterology2018，24，45： | 25 |
| 3 | Preoperative diagnosis of malignant pulmonary nodules in lung cancer screening with a radiomics nomogram显示文摘Background:Lung cancer is the most commonly diagnosed cancer worldwide.Its survival rate can be significantly improved by early screening.Biomarkers based on radiomics features have been found to provide important physiological information on tumors and considered as having the potential to be used in the early screening of lung cancer.In this study,we aim to establish a radiomics model and develop a tool to improve the discrimination between benign and malignant pulmonary nodules.Methods:A retrospective study was conducted on 875 patients with benign or malignant pulmonary nodules who underwent computed tomography(CT)examinations between June 2013 and June 2018.We assigned 612 patients to a training cohort and 263 patients to a validation cohort.Radiomics features were extracted from the CT images of each patient.Least absolute shrinkage and selection operator(LASSO)was used for radiomics feature selection and radiomics score calculation.Multivariate logistic regression analysis was used to develop a classification model and radiomics nomogram.Radiomics score and clinical variables were used to distinguish benign and malignant pulmonary nodules in logistic model.The performance of the radiomics nomogram was evaluated by the area under the curve(AUC),calibration curve and Hosmer-Lemeshow test in both the training and validation cohorts.Results:A radiomics score was built and consisted of 20 features selected by LASSO from 1288 radiomics features in the training cohort.The multivariate logistic model and radiomics nomogram were constructed using the radiomics score and patients’age.Good discrimination of benign and malignant pulmonary nodules was obtained from the training cohort(AUC,0.836;95%confidence interval[CI]:0.793-0.879)and validation cohort(AUC,0.809;95%CI:0.745-0.872).The Hosmer-Lemeshow test also showed good performance for the logistic regression model in the training cohort(P=0.765)and validation cohort(P=0.064).Good alignment with the calibration curve indicated the good performance of the nomogram.Conclusions:The established radiomics nomogram is a noninvasive preoperative prediction tool for malignant pulmonary nodule diagnosis.Validation revealed that this nomogram exhibited excellent discrimination and calibration capacities,suggesting its clinical utility in the early screening of lung cancer. | Ailing Liu Zhiheng Wang Yachao Yang Jingtao Wang Xiaoyu Dai Lijie Wang Yuan Lu Fuzhong Xue | 2020 | Cancer Communications2020，40，1： | 22 |
| 4 | A radiomic nomogram based on an apparent diffusion coefficient map for differential diagnosis of suspicious breast findings显示文摘Objective: To develop and validate a radiomic nomogram based on an apparent diffusion coefficient(ADC) map for differentiating benign and malignant lesions in suspicious breast findings classified as Breast Imaging Reporting and Data System(BI-RADS) category 4 on breast magnetic resonance imaging(MRI).Methods: Eighty-eight patients diagnosed with BI-RADS 4 findings on breast MRI in the First Affiliated Hospital of China Medical University from December 2014 to December 2015 were retrospectively analyzed in this study. Sixty-three were randomized electronically to establish forecasting models, and the other 25 were used for validation. Radiomic features based on the ADC map were generated automatically by Artificial Intelligence Kit software(A.K. software; GE Healthcare, China). Feature reduction was conducted using the Mann-Whitney test and Spearman correlation after pre-treatment. A prediction model of ADC radiomics was established by logistic linear regression and cross-validation. A nomogram was established based on ADC radiomic features,pharmacokinetics and clinical features, including the morphology and ADC value for breast BI-RADS 4 lesions on MRI.Results: A total of 396 radiomic features were extracted automatically by the A.K. software. Five features were selected after pre-processing, Mann-Whitney tests and Spearman correlation analysis. The area under the ROC curve of the prediction model comprising ADC radiomic features was 0.79 when the cutoff value was 0.45, and the accuracy, sensitivity and specificity were 80.0%, 0.813 and 0.778, respectively. A visualized differential nomogram based on the radiomic score, pharmacokinetics and clinical features was established. The decision curve showed good consistency.Conclusions: ADC radiomic features could provide an important reference for differential diagnosis between benign and malignant lesions in suspicious BI-RADS 4 lesions. The visualized nomogram based on ADC radiomic features, pharmacokinetics and clinical features may have good prospects for clinical application. | Bin Hu Ke Xu Zheng Zhang Ruimei Chai Shu Li Lina Zhang | 2018 | Chinese Journal of Cancer Research2018，30，4： | 15 |
| 5 | Construction and external validation of a nomogram that predicts lymph node metastasis in early gastric cancer patients using preoperative parameters显示文摘Objective: To create a nomogram to predict the incidence of lymph node metastasis(LNM) in early gastric cancer(EGC) patients and to externally validate the nomogram.Methods: To construct the nomogram,we retrospectively analyzed a primary cohort of 272 EGC patients.Univariate analysis and a binary logistic regression were performed.A nomogram predicting the incidence of LNM in EGC patients was created.The discrimination ability of the nomogram was measured using the concordance index(c-index),and the nomogram was also calibrated.Then,another prospective cohort of 81 patients was analyzed to validate the nomogram.Results: In the primary cohort,LNM was pathologically confirmed in 37(13.6%) patients.In multivariate analysis,the presence of an ulcer,the maximum lesion diameter observed via gastroscopy,the thickness of the lesion observed via endoscopic ultrasonography,and the presence of enlarged lymph nodes on computed tomography(CT) were independent risk factors for LNM.A nomogram was then created based on the regression model with the c-index of 0.905,and the calibration curve of the nomogram fell approximately on the ideal 45-degree line.The cut-off score of the nomogram was 110,and the sensitivity,specificity,positive predictive and negative predictive values of the nomogram in the primary cohort were 81.1%,86.0%,47.6% and 96.7%,respectively,and in the prospective validation cohort were 75.0%,91.0%,60.0% and 95.5%,respectively.The calibration curve of the external validation cohort was almost on the 45-degree line.Conclusions: We developed an effective nomogram predicting the incidence of LNM for EGC patients. | Yinan Zhang Yiqiang Liu Ji Zhang Xiaojiang Wu Xin Ji Tao Fu Ziyu Li Qi Wu Zhaode Bu Jiafu Ji | 2018 | Chinese Journal of Cancer Research2018，30，6： | 12 |
| 6 | Development and validation of a prediction model for microvascular invasion in hepatocellular carcinoma显示文摘BACKGROUND Microvascular invasion(MVI)is an important prognostic factor affecting early recurrence and overall survival in hepatocellular carcinoma(HCC)patients after hepatectomy and liver transplantation,but it can be determined only in surgical specimens.Accurate preoperative prediction of MVI is conducive to clinical decisions.AIM To develop and validate a preoperative prediction model for MVI in patients with HCC.METHODS Data from 454 patients with HCC who underwent hepatectomy at the First Affiliated Hospital of Nanjing Medical University between May 2016 and October 2019 were retrospectively collected.Then,the patients were nonrandomly split into a training cohort and a validation cohort.Logistic regression analysis was used to identify variables significantly associated with MVI that were then included in the nomogram.We evaluated the discrimination and calibration ability of the nomogram by using R software.RESULTS MVI was confirmed in 209(46.0%)patients by a pathological examination.Multivariate logistic regression analysis identified four risk factors independently associated with MVI:Tumor size[odds ratio(OR)=1.195;95%confidence interval(CI):1.107–1.290;P<0.001],number of tumors(OR=4.441;95%CI:2.112–9.341;P<0.001),neutrophils(OR=1.714;95%CI:1.036–2.836;P=0.036),and serumα-fetoprotein(20–400 ng/mL,OR=1.955;95%CI:1.055–3.624;P=0.033;>400 ng/mL,OR=3.476;95%CI:1.950–6.195;P<0.001).The concordance index was 0.79(95%CI:0.74–0.84)and 0.81(95%CI:0.74–0.89)in the training and validation cohorts,respectively.The calibration curves showed good agreement between the predicted risk by the nomogram and real outcomes.CONCLUSION We have developed and validated a preoperative prediction model for MVI in patients with HCC.The model could aid physicians in clinical treatment decision making. | Lin Wang Yue-Xinzi Jin Ya-Zhou Ji Yuan Mu Shi-Chang Zhang Shi-Yang Pan | 2020 | World Journal of Gastroenterology2020，26，14： | 12 |
| 7 | 骨质疏松患者经皮椎体成形后骨水泥渗漏风险分析及预测模型验证显示文摘背景:骨水泥渗漏是经皮椎体成形治疗最常见的并发症,但有关骨水泥出现渗漏的危险因素仍在争论中。目的:探讨经皮椎体成形后骨水泥渗漏的危险因素,并建立与验证预测模型。方法:选择2016年6月至2018年6月在柳州市人民医院脊柱外科接受经皮椎体成形治疗的骨质疏松性压缩骨折患者进行回顾性分析,共纳入385例,其中男77例,女308例。选取年龄、性别、骨密度、身高、体质量、体质量指数、住院时间、骨水泥量、手术时间、住院到手术时间、受伤到手术时间、是否多椎体骨折及类固醇药物使用对经皮椎体成形术后骨水泥渗漏的发生进行单因素和多因素分析,以确定相关的危险因素,同时建立预测模型并进行验证。研究通过柳州市人民医院的机构审查委员会伦理审查。结果与结论:①385例患者中81例出现骨水泥渗漏,单因素Logistic分析结果显示,骨水泥注射量、手术时长和是否多椎体骨折与术后骨水泥渗漏有关(P<0.05);多因素Logistic回归分析显示,更高的骨水泥注射量[OR=1.283,95%CI(1.004,1.640),P<0.05]、更长的手术时间[OR=1.0.15,95%CI(1.003,1.027),P<0.05]及多椎体骨折[OR=2.456,95%CI(1.461,4.130),P<0.05]患者有更大的骨水泥渗漏风险;②进一步建立临床预测模型(Nomogram)并对其进行验证,结果显示ROC=0.683,拟合优度检验结果P=0.592,提示该模型具有较好预测能力;③结果表明,骨水泥注射量、手术时长、多椎体骨折是经皮椎体成形术后骨水泥渗漏危险因素,Nomogram可以较准确预测经皮椎体成形术后骨水泥渗漏的发生。 | 李文乐 王浩胜 宁丽俊 张文石 高森 孙丽君 胡朝晖 | 2022 | 中国组织工程研究2022，26，10： | 11 |
| 8 | A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy显示文摘Background:Patients with hepatocellular carcinoma(HCC)undergoing surgical resection still have a high 5-year recurrence rate(~60%).With the development of laparoscopic hepatectomy(LH),few studies have compared the efficacy between LH and traditional surgical approach on HCC.The objective of this study was to establish a nomo-gram to evaluate the risk of recurrence in HCC patients who underwent LH.Methods:The clinical data of 432 patients,pathologically diagnosed with HCC,underwent LH as initial treatment and had surgical margin>1 cm were collected.The significance of their clinicopathological features to recurrence-free survival(RFS)was assessed,based on which a nomogram was constructed using a training cohort(n=324)and was internally validated using a temporal validation cohort(n=108).Results:Hepatitis B surface antigen(hazard ratio[HR],1.838;P=0.044),tumor number(HR,1.774;P=0.003),tumor thrombus(HR,2.356;P=0.003),cancer cell differentiation(HR,0.745;P=0.080),and microvascular tumor invasion(HR,1.673;P=0.007)were found to be independent risk factors for RFS in the training cohort,and were used for con-structing the nomogram.The C-index for RFS prediction in the training cohort using the nomogram was 0.786,which was higher than that of the 8th edition of the American Joint Committee on Cancer TNM classification(C-index,0.698)and the Barcelona Clinic Liver Cancer staging system(C-index,0.632).A high consistency between the nomogram prediction and actual observation was also demonstrated by a calibration curve.An improved predictive benefit in RFS and higher threshold probability of the nomogram were determined by receiver operating characteristic curve analysis,which was also confirmed in the validation cohort compared to other systems.Conclusions:We constructed and validated a nomogram able to quantify the risk of recurrence after initial LH for HCC patients,which can be clinically implemented in assisting the planification of individual postoperative surveil-lance protocols. | Yang-Xun Pan Jian-Cong Chen Ai-Ping Fang Xiao-Hui Wang Jin-Bin Chen Jun-Cheng Wang Wei He Yi-Zhen Fu Li Xu Min-Shan Chen Yao-Jun Zhang Qi-Jiong Li Zhong-Guo Zhou | 2019 | Cancer Communications2019，39，1： | 11 |
| 9 | Preoperative albumin levels predict prolonged postoperative ileus in gastrointestinal surgery显示文摘BACKGROUND Prolonged postoperative ileus(PPOI) is a prolonged state of 'pathological'gastrointestinal(GI) tract dysmotility. There are relatively few studies examining the influence of preoperative nutritional status on the development of PPOI in patients who underwent GI surgery. The association between preoperative albumin and PPOI has not been fully studied. We hypothesized that preoperative albumin may be an independent indicator of PPOI.AIM To analyze the role of preoperative albumin in predicting PPOI and to establish a nomogram for clinical risk evaluation.METHODS Patients were drawn from a prospective hospital registry database of GI surgery.A total of 311 patients diagnosed with gastric or colorectal cancer between June 2016 and March 2017 were included. Potential predictors of PPOI were analyzed by univariate and multivariable logistic regression analyses, and a nomogram for quantifying the presence of PPOI was developed and internally validated.RESULTS The overall PPOI rate was 21.54%. Advanced tumor stage and postoperative opioid analgesic administration were associated with PPOI. Preoperative albumin was an independent predictor of PPOI, and an optimal cutoff value of 39.15 was statistically calculated. After adjusting multiple variables, per unit or per SD increase in albumin resulted in a significant decrease in the incidence of PPOI of 8%(OR = 0.92, 95%CI: 0.85-1.00, P = 0.046) or 27%(OR = 0.73, 95%CI:0.54-0.99, P = 0.046), respectively. Patients with a high level of preoperative albumin(≥ 39.15) tended to experience PPOI compared to those with low levels(< 39.15)(OR = 0.43, 95%CI: 0.24-0.78, P = 0.006). A nomogram for predicting PPOI was developed [area under the curve(AUC) = 0.741] and internally validated by bootstrap resampling(AUC = 0.725, 95%CI: 0.663-0.799).CONCLUSION Preoperative albumin is an independent predictive factor of PPOI in patients who underwent GI surgery. The nomogram provided a model to screen for early indications in the clinical setting. | Wen-Quan Liang Ke-Cheng Zhang Hua Li Jian-Xin Cui Hong-Qing Xi Ji-Yang Li Ai-Zhen Cai Yu-Hua Liu Wang Zhang Lan Zhang Bo Wei Lin Chen | 2020 | World Journal of Gastroenterology2020，26，11： | 10 |
| 10 | Incidence trends and survival prediction of hepatoblastoma in children:a population-based study显示文摘Background:Hepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children.Due to limited epidemiological data,therapy for hepatoblastoma tends to be individualized.This study aimed to evaluate incidence trends of hepatoblastoma and to develop a nomogram to predict the survival of children with newly diagnosed hepatoblastoma on a population-based level.Methods:Individuals up to 18 years of age with hepatoblastoma recorded in 18 registries of the Surveillance,Epi-demiology,and End Results(SEER)database between 2004 and 2015 were examined.Joinpoint regression analyses were applied to assess incidence trends in annual percentage change(APC).Multivariable Cox regression was used to identify factors associated with overall survival(OS).A nomogram was constructed to predict OS in individual cases based on independent predictors.Concordance index(C-index)and calibration curves were used to evaluate predic-tive performance.Results:Between 2004 and 2015,hepatoblastoma incidence increased significantly(APC,2.2%;95%confidence interval[CI]0.5%to 3.8%,P<0.05).In particular,this increase was observed among 2-to 4-year-old patients,males,and African-Americans.The 5-and 10-year OS rates were 81.5%and 81.0%,respectively.Age of 2 to 4 years,Afri-can-American ethnicity,and no surgery were independent predictors for short OS.Distant disease at presentation was found not to be an independent factor of survival.The nomogram had a C-index of 0.79(95%CI 0.74-0.84)with appropriate calibration curve fitting.Conclusions:We constructed a nomogram that integrates common factors associated with survival for hepatoblas-toma patients.It provides accurate prognostic prediction for children with hepatoblastoma. | Jincheng Feng Georgios Polychronidis Ulrike Heger Giovanni Frongia Arianeb Mehrabi Katrin Hoffmann | 2019 | Cancer Communications2019，39，1： | 10 |
| 11 | Primary site and regional lymph nodeinvolvement are independent prognosticfactors for early?stage extranodal nasal?typenatural killer/T cell lymphoma显示文摘Background:Nasal-type extranodal natural killer/T-cell lymphoma(ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract.However,it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement.The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL.Methods:To develop a nomogram,we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011.The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index(C-index) and calibration curve.Results:The 5-year overall survival(OS) and progression-free survival(PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL(OS:68.2%vs.46.0%,P = 0.030;PFS:53.4%vs.26.6%,P = 0.010).The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage HE ENKTCL(OS:66.3%vs.59.2%,P = 0.003;PFS:51.4%vs.40.3%,P = 0.009).Multivariate analysis showed that age >60 years,ECOG performance status score >2,elevated lactate dehydrogenase(LDH) level,extranasal primary site,and regional lymph node involvement were significantly associated with lower 5-year OS rate;age >60 years,elevated LDH level,extra-nasal primary site,and regional lymph node involvement were significantly associated with lower 5-year PFS rate.The nomogram included the primary site and regional lymph node involvement based on multivariate analysis.The calibration curve showed good agreement between the predicted and actual 5-year OS and PFS rates,and the C-indexes of the nomogram for the OS and PFS rates were 0.697 and 0.634,respectively.Conclusions:The primary site and regional lymph node involvement are independent prognostic factors for earlystage ENKTCL treated with chemotherapy followed by definitive radiotherapy. | Shao‑Qing Niu Yong Yang Yi‑Yang Li Ge Wen Liang Wang Zhi‑Ming Li Han‑Yu Wang Lu‑Lu Zhang Yun‑Fei Xia Yu‑Jing Zhang | 2016 | Chinese Journal of Cancer2016，35，5： | 8 |
| 12 | Liver fibrosis index-based nomograms for identifying esophageal varices in patients with chronic hepatitis B related cirrhosis显示文摘BACKGROUND Esophageal varices(EV)are the most fatal complication of chronic hepatitis B(CHB)related cirrhosis.The prognosis is poor,especially after the first upper gastrointestinal hemorrhage.AIM To construct nomograms to predict the risk and severity of EV in patients with CHB related cirrhosis.METHODS Between 2016 and 2018,the patients with CHB related cirrhosis were recruited and divided into a training or validation cohort at The First Affiliated Hospital of Wenzhou Medical University.Clinical and ultrasonic parameters that were closely related to EV risk and severity were screened out by univariate and multivariate logistic regression analyses,and integrated into two nomograms,respectively.Both nomograms were internally and externally validated by calibration,concordance index(C-index),receiver operating characteristic curve,and decision curve analyses(DCA).RESULTS A total of 307 patients with CHB related cirrhosis were recruited.The independent risk factors for EV included Child-Pugh class[odds ratio(OR)=7.705,95%confidence interval(CI)=2.169-27.370,P=0.002],platelet count(OR=0.992,95%CI=0.984-1.000,P=0.044),splenic portal index(SPI)(OR=3.895,95%CI=1.630-9.308,P=0.002),and liver fibrosis index(LFI)(OR=3.603,95%CI=1.336-9.719,P=0.011);those of EV severity included Child-Pugh class(OR=5.436,95%CI=2.112-13.990,P<0.001),mean portal vein velocity(OR=1.479,95%CI=1.043-2.098,P=0.028),portal vein diameter(OR=1.397,95%CI=1.021-1.912,P=0.037),SPI(OR=1.463,95%CI=1.030-2.079,P=0.034),and LFI(OR=3.089,95%CI=1.442-6.617,P=0.004).Two nomograms(predicting EV risk and severity,respectively)were well-calibrated and had a favorable discriminative ability,with C-indexes of 0.916 and 0.846 in the training cohort,respectively,higher than those of other predictive indexes,like LFI(C-indexes=0.781 and 0.738),SPI(C-indexes=0.805 and 0.714),ratio of platelet count to spleen diameter(PSR)(C-indexes=0.822 and 0.726),King’s score(C-indexes=0.694 and 0.609),and Lok index(C-indexes=0.788 and 0.700).The areas under the curves(AUCs)of the two nomograms were 0.916 and 0.846 in the training cohort,respectively,higher than those of LFI(AUCs=0.781 and 0.738),SPI(AUCs=0.805 and 0.714),PSR(AUCs=0.822 and 0.726),King’s score(AUCs=0.694 and 0.609),and Lok index(AUCs=0.788 and 0.700).Better net benefits were shown in the DCA.The results were validated in the validation cohort.CONCLUSION Nomograms incorporating clinical and ultrasonic variables are efficient in noninvasively predicting the risk and severity of EV. | Shi-Hao Xu Fang Wu Le-Hang Guo Wei-Bing Zhang Hui-Xiong Xu | 2020 | World Journal of Gastroenterology2020，26，45： | 8 |
| 13 | 神经重症患者螺旋型鼻肠管幽门后置管241例分析及可视化预测模型的建立研究显示文摘目的分析神经重症患者螺旋型鼻肠管幽门后置管的影响因素,并建立可视化的预测模型。方法回顾性分析2012年5月至2018年3月广东省人民医院神经ICU内放置螺旋型鼻肠管且操作前应用促胃肠动力药的重症患者。所有置管常规24 h后行床边X线评估,管端位于幽门后为置管成功。按置管结局分为成功组和失败组。统计患者的一般资料、APACHEⅡ评分、急性胃肠功能损伤(AGI)分级、治疗措施及药物使用等。采用单因素分析和多元Logistic回归分析置管成功的影响因素,并建立预测模型和Nomogram(列线图)。结果入选患者共241例,男146例,女95例,年龄中位数58岁,APACHEⅡ评分中位数20分,AGI分级中位数I级。119例置管成功,122例置管失败,总体成功率49.4%。Logistic回归分析表明影响置管的因素包括APACHEⅡ评分、镇静镇痛药、缩血管药、AGI分级。建立的预测模型和Nomogram的ROC曲线下面积为0.8002。结论 APACHEⅡ评分、镇静镇痛药、缩血管药、AGI分级影响神经重症患者螺旋型鼻肠管幽门后置管的成功率。据此建立的预测模型具有中等偏上的效能,可视化为Nomogram后,可为临床医师提供一个方便快捷的决策辅助工具。 | 胡林辉 欧阳欣 胡北 吕波 孙诚 袁炳斌 陈纯波 | 2019 | 中国实用内科杂志2019，39，4： | 8 |
| 14 | 基于Ishak炎症评分构建的Nomogram肝细胞癌术后复发预测模型的研究显示文摘目的 探讨Ishak炎症评分系统和肝细胞癌(HCC)患者临床病理学特征与根治性肝切除术后复发的关系,并建立Nomogram术后复发预测模型.方法 收集2006年1月至2009年12月重庆医科大学附属第一医院肝胆外科收治的326例接受根治性肝切除术的HCC患者病例资料作为研究组,2010年1月至2012年12月收治的110例HCC患者资料作为验证组.利用研究组的随访资料和癌旁组织Ishak炎症评分建立Nomogram复发预测模型,通过验证组对模型预测的准确性进行验证.采用Kaplan-Meier进行单因素生存分析,有统计学意义的指标进一步纳入Cox比例风险回归模型进行多因素生存分析;采用受试者工作特征曲线(ROC)检测模型预测的准确性.结果 根据患者癌旁组织Ishak炎症评分,将患者分为4级:Ⅰ级(1~4分),Ⅱ级(5~8分),Ⅲ级(9~12分)和Ⅳ级(13~18分).Ishak炎症评分与患者的AST(中位数36.0 U/L,P=0.011)、γ-谷氨酰转肽酶(中位数54.5 U/L,P=0.005)、HBV-DNA定量(20.5%〉106拷贝数/ml,P=0.015)和微血管侵犯(26.7%阳性,P=0.021)有关.多因素分析结果显示,患者的癌旁Ishak炎症评分(P=0.007)、HNB-DNA定量(P〈0.01)、肿瘤最大径(P=0.001)和微血管侵犯(P=0.001)与HCC患者的复发有关.将上述四个指标纳入Nomogram复发预测模型.校准曲线显示,预测复发和实际复发有较高的一致性.C指数和ROC曲线下面积分析结果显示,Nomogram预测能力明显高于AJCC和BCLC临床分期的预测能力.验证组的结果与实验组结果基本一致.结论 基于Ishak炎症评分构建的Nomogram能够预测HCC的复发,可能有助于HCC患者术后复发的监测. | 罗晓勇 杜成友 魏续福 蒋宁 李明 廖锐 | 2018 | 中华外科杂志2018，56，2： | 8 |
| 15 | Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer显示文摘BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of PPOI.We hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer patients.AIM To investigate the risk factors for PPOI and establish a nomogram for clinical risk estimation.METHODS Between June 2016 and March 2017,the data of 162 patients with gastrectomy were obtained from a prospective and observational registry database.Clinical data of patients who fulfilled the criteria were obtained.Univariate and multivariable logistic regression models were performed to detect the relationship between variables and PPOI.A nomogram for PPOI was developed and verified by bootstrap resampling.The calibration curve was employed to detect the concentricity between the model probability curve and ideal curve.The clinical usefulness of our model was evaluated using the net benefit curve.RESULTS This study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent gastrectomy.The incidence of PPOI was 19.75%in patients with gastrectomy.Age older than 60 years,open surgery,advanced stage(III–IV),and postoperative use of opioid analgesic were independent risk factors for PPOI.We developed a simple and easy-to-use prediction nomogram of PPOI after gastrectomy.This nomogram had an excellent diagnostic performance[area under the curve(AUC)=0.836,sensitivity=84.4%,and specificity=75.4%].This nomogram was further validated by bootstrapping for 500 repetitions.The AUC of the bootstrap model was 0.832(95%CI:0.741–0.924).This model showed a good fitting and calibration and positive net benefits in decision curve analysis.CONCLUSION We have developed a prediction nomogram of PPOI for gastric cancer.This novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients. | Wen-Quan Liang Ke-Cheng Zhang Jian-Xin Cui Hong-Qing Xi Ai-Zhen Cai Ji-Yang Li Yu-Hua Liu Jie Liu Wang Zhang Peng-Peng Wang Bo Wei Lin Chen | 2019 | World Journal of Gastroenterology2019，25，38： | 8 |
| 16 | 列线图可预测首发缺血性脑卒中患者的复发显示文摘目的探索影响首发缺血性脑卒中幸存者复发的危险因素,建立复发预测模型并使用列线图将预测结果可视化。方法收集2010年1月~2018年12月入住四川大学华西医院神经内科且符合纳入标准的首发缺血性脑卒中幸存者,共821例幸存者纳入研究,利用R软件对初始人群进行随机抽样,70%纳入训练集建立模型,30%纳入验证集。应用Cox比例风险回归模型对影响首发缺血性脑卒中幸存者复发的因素进行多因素分析,并使用R软件的rms包构造列线图,建立可视化的预测模型。利用Cindex和校准曲线来评价模型的预测效果。结果 821例幸存者中,患者3年复发率为16.81%,5年复发率为19.98%;训练集经Cox回归模型多因素分析,年龄>65岁(HR=2.596,P=0.024)、年龄45~64岁(HR=2.510,P=0.006)、mRS评分≥3分(HR=2.284,P=0.004)、冠心病史(HR=1.353,P=0.034)是影响复发的危险因素;并由此建立列线图,3年(5年)复发预测模型的C-index为0.640(0.671)。结论首发缺血性脑卒中幸存者复发的影响因素是年龄、mRS评分和周围血管病史,列线图在首发缺血性脑卒中复发预测中有较高的区分度和预测力。 | 刘瑾 杨燕玲 严可 朱彩蓉 蒋敏 | 2022 | 南方医科大学学报2022，42，1： | 7 |
| 17 | 基于四种炎症反应标志物构建预测肝细胞癌患者预后的Nomogram模型显示文摘目的构建炎症反应标志物结合其他常规临床指标预测肝细胞癌患者术后半年、1年及2年的无复发生存率(RFS)及总体生存率(OS)的Nomogram模型。方法回顾性分析北京朝阳急诊抢救中心、空军特色医学中心2013年1月~2018年1月期间行首次肝切除术治疗的314例肝细胞癌(HCC)患者资料作为实验组。选取解放军总医院2011年1月~2016年1月收治的106例肝切除术的HCC患者作为外部验证组。采用单因素和多因素Cox比例风险模型分析实验组HCC患者复发及死亡的独立危险因素,根据独立危险因素构建Nomogram模型。采用外部验证组进行Nomogram模型效能验证。结果实验组患者中,174例患者复发,中位无复发生存时间26个月,半年RFS 26.8%,1年RFS 43.9%,2年RFS 68.8%。142例患者死亡,中位生存时间30个月,半年OS 5.9%,1年OS 23.6%,2年OS 63.1%。外部验证组患者中,63例患者复发,中位无复发生存时间28个月,半年RFS 26.4%,1年RFS 45.3%,2年RFS 54.7%,58例患者死亡,中位生存时间31个月,半年OS 7.5%,1年OS 25.5%,2年OS 46.6%。肿瘤大小(>6.0 cm,HR:1.447)、血管侵犯(是,HR:1.408)、总胆红素(>0.94 mg/dl,HR:1.949)、中性粒细胞与淋巴细胞比值(>2.54,HR:2.843)、白蛋白与球蛋白比值(≤0.88,HR:2.447)是HCC患者复发的独立危险因素(P<0.05)。肿瘤大小(>6.0 cm,HR:2.207)、血管侵犯(是,HR:1.529)、中性粒细胞与淋巴细胞比值(>2.54,HR:2.708)是HCC患者死亡的独立危险因素(P<0.05)。半年RFS、1年RFS、2年RFS的C-index分别为0.764(95%CI:0.677~0.854)、0.710(95%CI:0.615~0.824)、0.673(95%CI:0.601~0.786)。半年OS、1年OS、2年OS的C-index分别为0.729(95%CI:0.648~0.841)、0.708(95%CI:0.608~0.813)、0.664(95%CI:0.618~0.771)。结论本研究构建预测HCC患者预后的Nomogram模型可能有助于指导临床医生完善术前治疗计划,为患者提供个体化治疗提供思路。 | 冯志强 杨子旋 韩山山 商玉涛 赵君会 顾万清 杨庆民 吴洁莹 盛军 郭晓东 | 2020 | 中华肝胆外科杂志2020，26，6： | 7 |
| 18 | 妊娠期高血压疾病的炎症反应标志物及其产后发生慢性高血压的预测模型研究显示文摘目的研究妊娠期高血压疾病(HDP)孕产妇的炎症反应标志物并构建预测产后发生慢性高血压(CH)的Nomogram模型。方法选取2016年1月至2018年1月淮南东方总院妇产科收取的337例进行产前检查及分娩的HDP孕产妇作为研究对象。收集其妊娠24~28周时的中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)及血小板与淋巴细胞比值(PLR)。根据受试者工作特征(ROC)曲线及多元Logistic回归模型结果构建Nomogram模型。结果随访2.5年后,112例发生CH(CH组),225例未发生CH(非CH组)。CH组年龄、体重指数(BMI)、吸烟比例、高血压家族史比例、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞、淋巴细胞、NLR、LMR、PLR高于CH组,差异具有统计学意义(P<0.05)。年龄、BMI、SBP、DBP、MAP、WBC、NLR、LMR、PLR曲线下面积(AUC)分别为0.877、0.719、0.764、0.744、0.686、0.757、0.844、0.826、0.796;最佳截断值分别为30岁、24.5kg/m^(2)、147mmHg、90mmHg、107mmHg、8.24×10^(9)/L、4.13、4.26、141.65。年龄、BMI、高血压家族史、SBP、NLR及LMR是HDP孕产妇产后2.5年发生CH的独立危险因素(P<0.05)。内部验证结果显示C-index为0.877(95%CI:0.710~0.912)。结论本研究构建的Nomogram模型有助于对HDP孕产妇在妊娠中期进行早期的心血管疾病(CVD)风险筛查。 | 杜娟 王燕 江海燕 郑晓燚 | 2021 | 中国性科学2021，30，10： | 6 |
| 19 | Analysis and external validation of a nomogram to predict peritoneal dissemination in gastric cancer显示文摘Objective:Peritoneal dissemination is difficult to diagnose by conventional imaging technologies.We aimed to construct a nomogram to predict peritoneal dissemination in gastric cancer(GC)patients.Methods:We retrospectively analyzed 1,112 GC patients in Sun Yat-sen University Cancer Center between2001 and 2010 as the development set and 474 patients from The Sixth Affiliated Hospital,Sun Yat-sen University between 2010 and 2016 as the validation set.The clinicopathological variables associated with gastric cancer with peritoneal dissemination(GCPD)were analyzed.We used logistic regression analysis to identify independent risk factors for peritoneal dissemination.Then,we constructed a nomogram for the prediction of GCPD and defined its predictive value with a receiver operating characteristic(ROC)curve.External validation was performed to validate the applicability of the nomogram.Results:In total,250 patients were histologically identified as having peritoneal dissemination.Logistic regression analysis demonstrated that age,sex,tumor location,tumor size,signet-ring cell carcinoma(SRCC),T stage,N stage and Borrmann classification IV(Borrmann IV)were independent risk factors for peritoneal dissemination.We constructed a nomogram consisting of these eight factors to predict GCPD and found an optimistic predictive capability,with a C-index of 0.791,an area under the curve(AUC)of 0.791,and a 95%confidence interval(95%CI)of 0.762-0.820.The results found in the external validation set were also promising.Conclusions:We constructed a highly sensitive nomogram that can assist clinicians in the early diagnosis of GCPD and serve as a reference for optimizing clinical management strategies. | Xijie Chen Shi Chen Xinyou Wang Runcong Nie Dongwen Chen Jun Xiang Yijia Lin Yingbo Chen Junsheng Peng | 2020 | Chinese Journal of Cancer Research2020，32，2： | 6 |
| 20 | Development and validation of a nomogram for predicting the survival of patients with non-metastatic nasopharyngeal carcinoma after curative treatment显示文摘Background: The TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopathologic factors for predicting the overall survival(OS) of non-metastatic nasopharyngeal carcinoma(NPC) patients after curative treatments.Methods: We retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity-modulated radiation therapy(IMRT) between 2001 and 2010 were also retrieved to examine the extensibility of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index(c-index).Results: We identiied and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c-index of the nomogram was statistically higher than that of the 7th edition TNM staging system for predicting the survival in both the primary cohort(0.69 vs. 0.62) and the IMRT cohort(0.67 vs. 0.63).Conclusion: We developed and validated a novel nomogram that outperformed the TNM staging system in predicting the OS of non-metastatic NPC patients who underwent curative therapy. | Wenhua Liang Guanzhu Shen Yaxiong Zhang Gang Chen Xuan Wu Yang Li Anchuan Li Shiyang Kang Xi Yuan Xue Hou Peiyu Huang Yan Huang Hongyun Zhao Ying Tian Chong Zhao Li Zhang | 2016 | Chinese Journal of Cancer2016，35，12： | 6 |
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