| 林垚,张善福,杨传策,等.基于多参数临床指标构建肾上腺恶性肿瘤列线图预测模型[J].中国临床保健杂志,2025,28(5):648-652. |
| 基于多参数临床指标构建肾上腺恶性肿瘤列线图预测模型 |
| Construction of a nomogram prediction model for adrenal malignant tumors based on multiple clinical parameters |
| 投稿时间：2025-05-27 |
| DOI：10.3969/J.issn.1672-6790.2025.05.013 |
| 中文关键词: 肾上腺肿瘤 危险因素 列线图 预测 诊断技术和方法 |
| 英文关键词: Adrenal gland neoplasms Risk factors Nomograms Forecasting Diagnostic techniques and procedures 〖FL |
| 基金项目:安徽省自然科学基金项目(1808085MH29) |
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| 中文摘要: |
| 目的 探讨影响肾上腺肿瘤良恶性的危险因素,构建可视化列线图预测模型,提供一种无创术前风险评估工具。方法 回顾性分析2016年2月至2025年2月中国科学技术大学附属第一医院(安徽省立医院)泌尿外科手术的567例肾上腺肿瘤患者的临床资料。根据患者的病理类型,将患者分为肾上腺良性肿瘤组(549例)和肾上腺恶性肿瘤组(18例)。收集2组患者的年龄、体重指数(BMI)、性别、白细胞、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞、血小板、血红蛋白、白蛋白、血糖、肿瘤长径等相关临床参数,以及高血压、糖尿病等既往病史,比较2组患者的临床资料,筛选肾上腺恶性肿瘤的危险因素；基于上述危险因素构建列线图预测模型以术前评估肾上腺肿瘤性质。结果 年龄(OR=1.054,95%CI:1.010~1.100)、中性粒细胞与淋巴细胞比值(OR=1.434,95%CI:1.081~1.901)、血小板与淋巴细胞比值(OR=1.009,95%CI:1.000~1.017)和肿瘤长径(OR=1.411,95%CI:1.225~1.625)是肾上腺肿瘤呈恶性的危险因素,上述危险因素构建的列线图预测模型的诊断效能为0.882,敏感性为83.33%,特异性为85.25%。结论 可视化列线图预测模型术前可有效评估肾上腺肿瘤的性质,有助于术前风险评估。 |
| 英文摘要: |
| Objective To explore the preoperative risk factors influencing the benign or malignant nature of adrenal tumors,and develop a visual nomogram prediction model.Methods A retrospective analysis was conducted on the clinical data of 567 adrenal tumor patients who visited the department of urology at the First Affiliated Hospital of University of Science and Technology of China from February 2016 to February 2025.Based on the pathological types,the patients were divided into two groups:the adrenal benign tumor group (549 patients) and the malignant tumor group (18 patients).Clinical parameters including age,BMI,gender,white blood cells (WBC),neutrophils,lymphocytes,monocytes,eosinophils,basophils,platelets,hemoglobin,albumin,blood glucose,tumor diameter,as well as medical history of hypertension,diabetes,and other comorbidities,were collected for both groups.the clinical data between the two groups were compared.High-risk factors for adrenal malignant tumors were then identified,and a nomogram prediction model was constructed based on these high-risk factors to preoperatively assess the nature of adrenal tumors.Results The age (OR=1.054,95%CI:1.010-1.100),NLR (OR=1.434,95%CI:1.081-1.901),PLR (OR=1.009,95%CI:1.000-1.017),and tumor diameter (OR=1.411,95%CI:1.225-1.625) were significant high-risk factors for the malignancy of adrenal tumors.The nomogram model based on these high-risk factors exhibited a diagnostic performance of 0.882,with a sensitivity of 83.33% and a specificity of 85.25%.Conclusions This nomogram model can effectively assess the benign or malignant nature of adrenal tumors preoperatively,helping to establish a clear diagnosis before surgery,develop individualized treatment plans,and improve the effectiveness and safety of the surgery. |
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