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建立并验证预测口腔潜在恶性疾病恶性转化的列线图预测模型。

Development and validation of a nomogram prediction model for malignant transformation of oral potentially malignant disorders.

机构信息

Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing 100081, PR China.

Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, PR China.

出版信息

Oral Oncol. 2021 Dec;123:105619. doi: 10.1016/j.oraloncology.2021.105619. Epub 2021 Nov 21.

Abstract

OBJECTIVE

Oral potentially malignant disorders have increased the risk of oral squamous cell carcinoma. This study developed a nomogram model to assess the risks of malignant transformation of oral potentially malignant disorders.

MATERIALS AND METHODS

A retrospective analysis of patients diagnosed with oral potentially malignant disorders confirmed by pre-treatment biopsy was performed between 2010 and 2017 at the Peking University Hospital of Stomatology. The candidate risk factors for malignant transformation were screened from clinicopathological variables using Cox and stepwise regression analyses. The nomogram model was constructed based on the regression results and was validated through receiver operating characteristic curves and calibration curves. Decision curve analysis was used to estimate clinical usefulness.

RESULTS

A total of 6964 cases of oral potentially malignant disorders were assessed. The malignant transformation rate of oral potentially malignant disorders was 2.00%. Risk factors (age, site, kind of oral potentially malignant disorder, existence of dysplasia and its grade, and other cancers) derived from the regression analyses were entered into the nomogram model. Time-dependent receiver operating characteristic curve, calibration curve, and decision curve analyses showed high levels of predictive value and clinical relevance, although not for all oral potentially malignant disorders.

CONCLUSION

A specific dynamic nomogram could be adopted to predict the malignant transformation of oral potentially malignant disorders and implement interventions.

摘要

目的

口腔潜在恶性疾病增加了口腔鳞状细胞癌的风险。本研究旨在建立一种列线图模型,以评估口腔潜在恶性疾病恶性转化的风险。

材料与方法

回顾性分析了 2010 年至 2017 年在北京大学口腔医院经术前活检确诊为口腔潜在恶性疾病的患者。采用 Cox 和逐步回归分析筛选恶性转化的候选风险因素。基于回归结果构建列线图模型,并通过接受者操作特征曲线和校准曲线进行验证。决策曲线分析用于评估临床实用性。

结果

共评估了 6964 例口腔潜在恶性疾病患者。口腔潜在恶性疾病的恶性转化率为 2.00%。回归分析得到的风险因素(年龄、部位、口腔潜在恶性疾病类型、是否存在异型增生及其分级以及其他癌症)被纳入列线图模型。时间依赖性接受者操作特征曲线、校准曲线和决策曲线分析表明,该模型具有较高的预测价值和临床相关性,但并非适用于所有口腔潜在恶性疾病。

结论

采用特定的动态列线图可预测口腔潜在恶性疾病的恶性转化,并实施干预措施。

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