| 王星淇,龚亮,贾衡,等.基于垂体腺瘤术后临床资料建立复发预测模型[J].安徽医药,2023,27(3):576-579. |
| 基于垂体腺瘤术后临床资料建立复发预测模型 |
| A model to predict relapse of pituitary adenomas based on postoperative clinical data |
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| DOI：10.3969/j.issn.1009-6469.2023.03.034 |
| 中文关键词: 垂体腺瘤 肿瘤复发，局部 评分系统 预测效能 |
| 英文关键词: Pituitary adenomas Neoplasm recurrence, local Scoring system Predictive performance |
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| 中文摘要: |
| 目的 基于病人的临床资料建立一种易于实施的评分系统，对垂体腺瘤的复发做出预测。方法 回顾性选取2017年1月至2021年1月徐州医科大学附属医院垂体腺瘤病人作建模组，均接受经鼻内镜下垂体腺瘤切除术，平均随访时间大于1年。对可能引起术后复发的相关因素行统计学分析，依据已证相关特征建立评分系统，通过受试者操作特征曲线(ROC曲线)曲线下面积(AUC)评价该评分系统预测复发的能力，根据约登指数分析出评分临界值，另随访同期该院36例同种疾病病人作验证组，佐证评分系统的预测效能。结果 最终被纳入建模组病人157例。建模组中，28例(17.8%)的病人在>12个月的随访中出现复发；复发的可能性可通过Ki-67指数、改进后Knosp分级、大小及肿瘤残余进行预测(均P<0.05)；垂体腺瘤评分系统在预测肿瘤复发方面显示出良好的预测能力［AUC=0.92，95%CI:(0.85，0.98)］，约登指数最大值为0.752，提示最佳预测临界分数为3分，当评分≥3分时，肿瘤复发可能性高；验证组评分≥3分有7例，复发4例，评分<3分有29例，复发1例(P=0.002)；评分系统作为预测指标，准确率为0.889，较单一影响因素高。结论 垂体腺瘤评分系统较可靠地预测了垂体腺瘤的术后复发，以量化指标作为术后评估的一部分，可有效快速的对病人病情及预后做出预测，为后续治疗提供参考。 |
| 英文摘要: |
| Objective To develop an easy-to-implement scoring system based on patients' clinical data to predict the relapse of pitu?itary adenomas.Method Patients with pituitary adenoma in the Affiliated Hospital of Xuzhou Medical University from January 2017 to January 2021 were retrospectively selected as the modeling group, all of whom underwent endoscopic pituitary adenoma resection,with a mean follow-up time of >1 year. A statistical analysis of the factors associated with possible postoperative relapse was performed to create a scoring system based on known relevant characteristics. The ability of the scoring system to predict recurrence was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve (ROC curve). and then the scoring threshold was ana?lyzed according to Youden's J statistic. An additional same period 36 patients were followed up as a validation group to corroborate the predictive efficacy of this scoring system.Results 157 patients were finally included in the model building group, 28 patients (17.8%) in the modeling group had a relapse at 12 months follow-up. The likelihood of relapse was predicted by Ki-67 index, improved Knosp classification, tumor size, and tumor remnants (all predictions: P<0.05). The pituitary adenomas scoring system was a good predictor of tumor relapse [AUC=0.92, 95% CI: (0.85, 0.98)], with a maximum Jorden J statistic of 0.752, suggesting an optimal predictive threshold score of 3. High likelihood of tumor relapse when the score was ≥3. There were 7 cases with scores ≥3 and 4 cases of relapse in the vali?dation group. There were 29 cases with scores <3 and 1 case of relapse (P=0.002); the accuracy of the scoring system as a predictor was 0.889, which was higher than the single influencing factor.Conclusion The pituitary adenomas scoring system, which uses quantita?tive indicators as part of the postoperative evaluation, is a more reliable predictor of postoperative relapse of pituitary adenoma, and can efficiently and rapidly predict the patient's condition and prognosis, thus providing a reference for subsequent treatment. |
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