开发和验证在上泌尿道尿癌中进行内镜管理决策的术前诺图
Takahiro Nakamoto1,2, Takashi Yoshida3,4,5, Satoshi Katayama6
1Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
Annals of surgical oncology
|November 5, 2023
概括
一种新的诺基图准确地预测了低度的,非肌肉侵入性上泌尿道尿癌 (LG-NMI UTUC),改善了内镜管理 (EM) 的选择,并有助于UTUC患者的预后.
科学领域:
- 尿瘤学 尿瘤学
- 手术瘤学手术瘤学
- 诊断的准确性 诊断的准确性
背景情况:
- 精确的手术前预测低度的,非肌肉侵入性上泌尿道泌尿管癌 (LG-NMI UTUC) 对于选择适当的管理策略至关重要.
- 目前用于预测UTUC风险的模型在识别适合的候选人中存在局限性,以减少侵入性内镜管理 (EM).
研究的目的:
- 为预测LG-NMI UTUC.开发和验证一个手术前的指数表.
- 加强对UTUC的内镜管理 (EM) 患者的选择.
- 为了评估诺莫图的预后价值在疾病进展.
主要方法:
- 追溯分析了454名接受了彻底手术的患者 (第1组和第2组) 和26名接受EM治疗的患者 (第3组).
- 在第1队列数据上使用多变量逻辑回归开发名图.
- 与欧洲泌尿病学协会 (EAU) 和国家综合癌症网络 (NCCN) 模型相比,以对队列2的外部验证和对队列3的预后评价来比较诺莫грам准确性.
主要成果:
- 对于LG-NMI UTUC的独立预测因素包括在成像上缺乏侵入性疾病,缺少水,乳头架构和缺乏高档尿细胞学.
- 与传统模型 (0.759-0.821) 相比,开发的名图表显示出更高的预测准确性 (0.869),并显示出更高的净效益.
- 在外部验证 (队列2) 中证实了名图的有效性,并且它有效地分层了EM患者的无进展生存率 (队列3).
结论:
- 开发的手术前诺基图准确预测LG-NMI UTUC,有助于确定适合内镜管理的候选人.
- 诺米图表作为一个有价值的工具,用于预后分层在患者接受EM为UTUC.
- 该名录在线可用于临床使用.
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