Xian Shen1, Huanhu Zhao2, Xing Jin3, Junyu Chen4, Zhengping Yu4, Kuvaneshan Ramen5, Xiangwu Zheng6, Xiuling Wu7, Yunfeng Shan4, Jianling Bai8, Qiyu Zhang4, Qiqiang Zeng1. 1. Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China. 2. School of Pharmacy, Minzu University of China, Beijing, China. 3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fujian, China. 4. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 5. Dr. A.G Jeetoo Hospital, Port Louis, Mauritius. 6. Radiological Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 7. Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 8. Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
Abstract
BACKGROUND: Accurate diagnosis of intrahepatic cholangiocarcinoma (ICC) caused by intrahepatic lithiasis (IHL) is crucial for timely and effective surgical intervention. The aim of the present study was to develop a nomogram to identify ICC associated with IHL (IHL-ICC). METHODS: The study included 2,269 patients with IHL, who received pathological diagnosis after hepatectomy or diagnostic biopsy. Machine learning algorithms including Lasso regression and random forest were used to identify important features out of the available features. Univariate and multivariate logistic regression analyses were used to reconfirm the features and develop the nomogram. The nomogram was externally validated in two independent cohorts. RESULTS: The seven potential predictors were revealed for IHL-ICC, including age, abdominal pain, vomiting, comprehensive radiological diagnosis, alkaline phosphatase (ALK), carcinoembryonic antigen (CEA), and cancer antigen (CA) 19-9. The optimal cutoff value was 2.05 µg/L for serum CEA and 133.65 U/mL for serum CA 19-9. The accuracy of the nomogram in predicting ICC was 82.6%. The area under the curve (AUC) of nomogram in training cohort was 0.867. The AUC for the validation set was 0.881 from The Second Affiliated Hospital of Wenzhou Medical University, and 0.938 from The First Affiliated Hospital of Fujian Medical University. CONCLUSIONS: The nomogram holds promise as a novel and accurate tool to predict IHL-ICC, which can identify lesions in IHL in time for hepatectomy or avoid unnecessary surgical resection. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
BACKGROUND: Accurate diagnosis of intrahepatic cholangiocarcinoma (ICC) caused by intrahepatic lithiasis (IHL) is crucial for timely and effective surgical intervention. The aim of the present study was to develop a nomogram to identify ICC associated with IHL (IHL-ICC). METHODS: The study included 2,269 patients with IHL, who received pathological diagnosis after hepatectomy or diagnostic biopsy. Machine learning algorithms including Lasso regression and random forest were used to identify important features out of the available features. Univariate and multivariate logistic regression analyses were used to reconfirm the features and develop the nomogram. The nomogram was externally validated in two independent cohorts. RESULTS: The seven potential predictors were revealed for IHL-ICC, including age, abdominal pain, vomiting, comprehensive radiological diagnosis, alkaline phosphatase (ALK), carcinoembryonic antigen (CEA), and cancer antigen (CA) 19-9. The optimal cutoff value was 2.05 µg/L for serum CEA and 133.65 U/mL for serum CA 19-9. The accuracy of the nomogram in predicting ICC was 82.6%. The area under the curve (AUC) of nomogram in training cohort was 0.867. The AUC for the validation set was 0.881 from The Second Affiliated Hospital of Wenzhou Medical University, and 0.938 from The First Affiliated Hospital of Fujian Medical University. CONCLUSIONS: The nomogram holds promise as a novel and accurate tool to predict IHL-ICC, which can identify lesions in IHL in time for hepatectomy or avoid unnecessary surgical resection. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
Authors: F Donato; U Gelatti; A Tagger; M Favret; M L Ribero; F Callea; C Martelli; A Savio; P Trevisi; G Nardi Journal: Cancer Causes Control Date: 2001-12 Impact factor: 2.506
Authors: Tae Y Lee; Sang S Lee; Seok W Jung; Seong H Jeon; Sung-Cheol Yun; Hyoung-Chul Oh; Seunghyun Kwon; Sung K Lee; Dong W Seo; Myung-Hwan Kim; Dong J Suh Journal: Am J Gastroenterol Date: 2008-06-28 Impact factor: 10.864