Objective To establish a nomogram model based on preoperative clinical and ultrasonic data,and to explore its clinical value in predicting lymph node metastasis in ovarian cancer patients.Methods A total of 475 ovarian cancer patients confirmed by surgical pathology in our hospital were selected.They were randomly divided into a training set(n=333)and a validation set(n=142)at a ratio of 7∶3.There were 92 cases of lymph node metastasis(LNM group)and 241 cases without lymph node metastasis(NLNM group)in the training set.The clinical and ultrasonic data of LNM group and NLNM group were compared.Logistic regression analysis was applied to screen the independent influencing factors for predicting lymph node metastasis in ovarian cancer patients,and the nomogram was drawn.Receiver operating characteristic(ROC)curve was drawn,the area under the curve and consistency index(C-index)were used to evaluate the differentiation of the nomogram.Calibration curve and Brier score were used to evaluate the calibration degree.Decision curve was used to evaluate the clinical applicability.Results There were statistically significant differences in histological types,FIGO stage and tumor location between the two groups(all P<0.01).Additionally,the expression level of Ki-67,proportion of multifocality and maximum diameter in the NLNM group were lower than those in the LNM group,with statistically significant differences(all P<0.001).Tumor maximum diameter,multifocality and the expression level of Ki-67 were independent risk factors for predicting lymph node metastasis in ovarian cancer patients(OR=1.010,5.236,1.023,all P<0.01).ROC curve analysis showed that the area under the curve of the nomogram model for predicting lymph node metastasis in ovarian cancer patients in the training and validation sets were 0.819(95%CI:0.770～0.868)and 0.794(95%CI:0.717～0.870),and the C-index were 0.837(95%CI:0.811～0.894),0.749(95%CI:0.712～0.791),respectively,indicating good differentiation of the model.Calibration curve analysis showed that the calibration degree of the prediction curve and calibration curve judged by the nomogram model was higher in the training and the validation sets,Brier score were 0.22,0.38,indicating good consistency between predicted and actual outcomes,and the calibration degree was good.Decision curve analysis showed good clinical applicability of the nomogram model for predicting lymph node metastasis in ovarian cancer patients in the training and the validation sets.Conclusion The nomogram model based on preoperative clinical and ultrasonic data has a certain clinical value in predicting lymph node metastasis in ovarian cancer patients.
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