Objective To study the risk factors associated with malignant transformation of intraductal papillary mucinous neo-plasms of pancreas(IPMN)before operation,construct the risk prediction model of malignant transformation of IPMN,and evaluate its predictive performance and clinical value.Methods A retrospective case-control study was used to select 98 patients with IPMN who were admitted to the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2021 and assigned as the training group.Fifty-two IPMN patients from the Second Affiliated Hospital of Anhui Medical University and the First Affiliated Hospi-tal of University of Science and Technology of China during the same period were included as the verification group.Univariate and multivariate logistic regression analysis was used to screen out the risk factors related to IPMN malignant transformation in the training group,build a nomogram model,and conduct external verification of the model based on the data of the verification group.C index,calibration curve and receiver operating characteristic(ROC)were used to evaluate the model.Results Logistic regression analysis in the training group suggested that Dilation of main pancreatic duct10mm,enhancement of mural nodules,maximum tumor diameter 30mm and elevation of serum CA19-9 were independent risk factors for malignant transformation of IPMN,and these factors were in-cluded in the construction of a nomogram prediction model.The C index of the training group was 0.834(95％CI:0.744～0.924),and that of the verification group was 0.847(95％CI:0.733～0.960).When the ROC curve is drawn,the optimal cut-off value of the total score of the model is 124.0 points when the Jorden index is maximum,and the corresponding sensitivity and specificity are 82.8％and 71.0％,respectively.The calibration curve shows a good degree of fit,which indicates that the model has good prediction accuracy and sensitivity.Conclusions Dilation of main pancreatic duct≥10mm,enhancement of mural nodules,maximum tumor di-ameter ≥30mm and elevation of serum CA19-9 are independent risk factors for malignant degeneration of IPMN.The malignant risk prediction model of IPMN built on this basis has high clinical value and can provide references for the formulation of clinical diagnosis and treatment plans.
关键词
胰腺导管内乳头状粘液性肿瘤/预测模型/列线图/恶变风险
Key words
intraductal papillary mucinous neoplasms of pan-creas/prediction model/nomogram/malignant risk
万方数据