Development and Validation of a Nomogram Prediction Model for Endometrial Malignancy in Patients with Abnormal Uterine Bleeding

Jianhong Zhou; Hengchao Ruan; Suhan Chen; Jingyi Li; Linjuan Ma; Jie Luo; Yizhou Huang; Qian Ying

doi:10.3349/ymj.2022.0239

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자료유형: 학술저널

저자정보: Jianhong Zhou (Zhejiang University School of Medicine China) Hengchao Ruan (Zhejiang University School of Medicine China) Suhan Chen (Zhejiang University School of Medicine China) Jingyi Li (Zhejiang University School of Medicine China) Linjuan Ma (Zhejiang University School of Medicine China) Jie Luo (Zhejiang University School of Medicine China) Yizhou Huang (Zhejiang University School of Medicine China) Qian Ying (Zhejiang Cancer Hospital China)

저널정보: 연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제64권 제3호

발행연도: 2023.3

수록면: 197 - 203 (7page)

DOI: 10.3349/ymj.2022.0239

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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.

#Endometrial neoplasms #uterine hemorrhage #ultrasonography #risk assessment

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