nomogram
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Úvod: Tématem naší práce bylo srovnání Gleasonova skóre v biopsii a po radikální prostatektomii za účelem sestavení matematického modelu pro přesnější predikci gradingu karcinomu po prostatektomii již z úvodní biopsie. Materiál a metody: soubor zahrnoval 159 pacientů odoperovaných na našem pracovišti. Provedli jsme přehodnocení biopsií i pooperačních preparátů podle aktuálních doporučení patologů. Výsledky: V biopsii bylo 46,4?% preparátů zařazeno mezi středně diferencované a 53,5?% mezi nízce diferencované karcinomy, zatímco pooperačně bylo středně diferencovaných karcinomů pouze 21,3?% oproti 78,6?% nízce diferencovaných karcinomů. Z výsledků posunu Gleasonova skóre mezi biopsií a pooperačním nálezem jsme sestavili predikční tabulku. Závěr: prokázali jsme zcela evidentní zlepšení histologického hodnocení preparátů a vyšší korelaci mezi biopsií a pooperačním nálezem. Pomocí korelačních tabulek tak lze predikovat očekávané Gleasonovo skóre již z biopsie a nález tak zakomponovat do rozhodovacího algoritmu v terapii karcinomu prostaty.
Introduction: The aim of our study was to compare Gleason score in biopsy and after radical prostatectomy to form a mathematical model for more accurate prediction of carcinoma grading after prostatectomy already from initial biopsy. Material and methods: our group included 159 patients after radical prostatectomy at our institution. We perform reevaluation of bioptic and postoperative specimens according to new recommendation of pathologists. Results: in biopsies there were 46,4% specimens included into intermediate grade and 53,5% specimens included into high grade cancers while after prostatectomy there were only 21,3% intermediate grade and 78,6% high grade cancers. From these Gleason scores shifts afterward we formed a predictive table. Conclusion: we approved quite evident histologic evaluation improvement and higher correlation between bioptic and postoperative findings. Thus we can predict expectable Gleason score already from biopsy and incorporate this finding into decision making algorithm in prostate cancer therapy.
- MeSH
- biopsie metody využití MeSH
- diagnostické techniky urologické využití MeSH
- histologie normy trendy MeSH
- interpretace statistických dat MeSH
- lidé MeSH
- nádory prostaty komplikace patofyziologie prevence a kontrola MeSH
- nomogramy MeSH
- prostatektomie metody trendy využití MeSH
- prostatický specifický antigen izolace a purifikace MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
- MeSH
- choriogonadotropin * krev MeSH
- dospělí MeSH
- kvantitativní polymerázová řetězová reakce metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrosatelitní repetice MeSH
- mladý dospělý MeSH
- mola hydatidosa klasifikace krev patofyziologie MeSH
- nomogramy * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
BACKGROUND: Recurrence of immunoglobulin A nephropathy (IgAN) limits graft survival in kidney transplantation. However, predictors of a worse outcome are poorly understood. METHODS: Among 442 kidney transplant recipients (KTRs) with IgAN, 83 (18.8%) KTRs exhibited biopsy-proven IgAN recurrence between 1994 and 2020 and were enrolled in the derivation cohort. A multivariable Cox model predicting allograft loss based on clinical data at the biopsy and a web-based nomogram were developed. The nomogram was externally validated using an independent cohort (n = 67). RESULTS: Patient age <43 years {hazard ratio [HR] 2.20 [95% confidence interval (CI) 1.41-3.43], P < .001}, female gender [HR 1.72 (95% CI 1.07-2.76), P = .026] and retransplantation status [HR 1.98 (95% CI 1.13-3.36), P = .016] were identified as independent risk factors for IgAN recurrence. Patient age <43 years [HR 2.77 (95% CI 1.17-6.56), P = .02], proteinuria >1 g/24 hours [HR 3.12 (95% CI 1.40-6.91), P = .005] and C4d positivity [HR 2.93 (95% CI 1.26-6.83), P = .013] were found to be associated with graft loss in patients with IgAN recurrence. A nomogram predicting graft loss was constructed based on clinical and histological variables, with a C statistic of 0.736 for the derivation cohort and 0.807 for the external validation cohort. CONCLUSIONS: The established nomogram identified patients with recurrent IgAN at risk for premature graft loss with good predictive performance.
- MeSH
- alografty patologie MeSH
- dospělí MeSH
- IgA nefropatie * komplikace chirurgie MeSH
- ledviny patologie MeSH
- lidé MeSH
- nomogramy MeSH
- přežívání štěpu MeSH
- prognóza MeSH
- recidiva MeSH
- retrospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Historical nomograms for the prediction of cancer on prostate biopsy, developed in the sextant biopsy era are no more accurate today. The aim of this study was an independent external validation of a 10-core biopsy nomogram by Chun et al. (2007). MATERIAL AND METHODS: A total of 322 patients who presented for their initial biopsy in a tertiary care center and had all the necessary data available were included in the retrospective analysis. To validate the nomogram, receiver operator characteristic (ROC) curves and calibration plots were constructed. RESULTS: Area under the ROC curve calculated for our data using the nomogram was 0.773, similar to that reported originally. However, the nomogram systematically overestimated prostate cancer risk, which, for our data, could be resolved by subtracting 24 points from the total number of points of the nomogram. CONCLUSIONS: The nomogram yielded overall good predictive accuracy as measured by the area under the ROC curve, but it systematically overestimated PC probability in individual patients. However, we showed how the nomogram could easily be adapted to our patient sample, resolving the bias issue.
- Publikační typ
- časopisecké články MeSH
- MeSH
- antropometrie MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- nomogramy MeSH
- tělesné váhy a míry MeSH
- Check Tag
- lidé MeSH
PURPOSE: Based on data retrieved from a comprehensive multicenter database, we externally validated a published postoperative nomogram for the prediction of disease-specific survival (DSS) in patients with papillary renal cell carcinoma (papRCC). METHODS: A multicenter database containing data of 2325 patients with surgically treated papRCC was used as validation cohort. After exclusion of patients with missing data and patients included in the development cohort, 1372 patients were included in the final analysis. DSS-probabilities according to the nomogram were calculated and compared to actual DSS-probabilities. Subsequently, calibration plots and decision curve analyses were applied. RESULTS: The median follow-up was 38 months (IQR 11.8-80.7). Median DSS was not reached. The c-index of the nomogram was 0.71 (95% CI 0.60-0.83). A sensitivity analysis including only patients operated after 1998 delivered a c-index of 0.84 (95% CI 0.77-0.92). Calibration plots showed slight underestimation of nomogram-predicted DSS in probability ranges below 90%: median nomogram-predicted 5-year DSS in the range below 90% was 55% (IQR 20-80), but the median actual 5-year DSS in the same group was 58% (95% CI 52-65). Decision-curve analysis showed a positive net-benefit for probability ranges between a DSS probability of 5% and 85%. CONCLUSIONS: The nomogram performance was satisfactory for almost all DSS probabilities; hence it can be recommended for application in clinical routine and for counseling of patients with papRCC.
- MeSH
- databáze faktografické MeSH
- karcinom z renálních buněk mortalita patologie chirurgie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy MeSH
- multicentrické studie jako téma MeSH
- nádory ledvin mortalita patologie chirurgie MeSH
- nomogramy * MeSH
- pooperační období MeSH
- prognóza MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
