|
KMID : 0311120230640030197
|
|
Yonsei Medical Journal
2023 Volume.64 No. 3 p.197 ~ p.203
|
|
|
Development and Validation of a Nomogram Prediction Model for Endometrial Malignancy in Patients with Abnormal Uterine Bleeding
|
|
Hengchao Ruan
Suhan Chen
Jingyi Li
Linjuan Ma
Jie Luo
|
|
|
Abstract
|
|
|
Purpose: This study aimed to identify the risk factors and sonographic variables that could be integrated into a predictive model for endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) in women with abnormal uterine bleeding (AUB).
Materials and Methods: This retrospective study included 1837 patients who presented with AUB and underwent endometrial sampling. Multivariable logistic regression was developed based on clinical and sonographic covariates [endometrial thickness (ET), resistance index (RI) of the endometrial vasculature] assessed for their association with EC/AEH in the development group (n=1369), and a predictive nomogram was proposed. The model was validated in 468 patients.
Results: Histological examination revealed 167 patients (12.2%) with EC or AEH in the development group. Using multivariable logistic regression, the following variables were incorporated in the prediction of endometrial malignancy: metabolic diseases [odds ratio (OR)=7.764, 95% confidence intervals (CI) 5.042?11.955], family history (OR=3.555, 95% CI 1.055?11.971), age ≥40 years (OR=3.195, 95% CI 1.878?5.435), RI ≤0.5 (OR=8.733, 95% CI 4.311?17.692), and ET ≥10 mm (OR=8.479, 95% CI 5.440?13.216). A nomogram was created using these five variables with an area under the curve of 0.837 (95% CI 0.800?0.874). The calibration curve showed good agreement between the observed and predicted occurrences. For the validation group, the model provided acceptable discrimination and calibration.
Conclusion: The proposed nomogram model showed moderate prediction accuracy in the differentiation between benign and malignant endometrial lesions among women with AUB.
|
|
|
KEYWORD
|
|
|
Endometrial neoplasms, uterine hemorrhage, ultrasonography, risk assessment
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|