A Nomogram-based Model to Predict Neoplastic Risk for Patients with Gallbladder Polyps

Abstract

Background and Aims: Gallbladder polyp (GBP) assessment aims to identify the early stages of gallbladder carcinoma. Many studies have analyzed the risk factors for malignant GBPs. In this retrospective study, we aimed to establish a more accurate predictive model for potential neoplastic polyps in patients with GBPs. Methods: We developed a nomogram-based model in a training cohort of 233 GBP patients. Clinical information, ultrasonographic findings, and blood test findings were analyzed. Mann-Whitney U test and multivariate logistic regression analyses were used to identify independent predictors and establish the nomogram model. An internal validation was conducted in 225 consecutive patients. Performance and clinical benefit of the model were evaluated using receiver operating characteristic curves and decision curve analysis (DCA), respectively. Results: Age, cholelithiasis, carcinoembryonic antigen, polyp size, and sessile shape were confirmed as independent predictors of GBP neoplastic potential in the training group. Compared with five other proposed prediction methods, the established nomogram model presented better discrimination of neoplastic GBPs in the training cohort (area under the curve [AUC]: 0.846) and the validation cohort (AUC: 0.835). DCA demonstrated that the greatest clinical benefit was provided by the nomogram compared with the other five methods. Conclusions: Our developed preoperative nomogram model can successfully be used to evaluate the neoplastic potential of GBPs based on simple clinical variables that maybe useful for clinical decisionmaking.

Prediction of neoplastic gallbladder polyps in patients with different age level based on preoperative ultrasound: a multi-center retrospective real-world study

“…Therefore, establishing predictive models based on independent risk factors can effectively improve the diagnostic ability. At present, the prediction models developed for neoplastic polyps or GPs with malignant tendency were general population models, and there are no prediction models for neoplastic polyps in the young adults patients or neoplastic polyps in elderly patients [ 12 , 21 – 23 ]. We previously established a nomogram prediction model for long diameter10-15 mm GPs with malignant tendency, but did not provide follow-up and treatment strategies for different age groups [ 24 ].…”

“…In addition, the prevalence of neoplastic polyps increases sharply with age and is associated with GBC [ 5 , 12 , 13 ]. An age criterion is also commonly conducted to guide management [ 10 ], unfortunately, the guidelines do not recommend follow-up strategies for different age groups.…”

Advances in the management of gallbladder polyps: establishment of predictive models and the rise of gallbladder-preserving polypectomy procedures

“…✓ The consistency index of the model was 0.778 and the internal validation was 0.768. Zhang X’s 2021 Model [ 43 ] 2021-06 Ultrasound ✓ Age ✓ Cholelithiasis ✓ CEA ✓ Polyp size ✓ Sessile ✓ The formula for neoplastic risk in patients with gallbladder polyps was: Y = 1.194 × [age] + 1.177 × [cholelithiasis] + 1.171 × [CEA] + 1.112 × [polyp size] + 1.066 × [sessile] − 3.944. ✓ The AUC was 0.846 and 0.835 in the training and validation cohorts, respectively.…”

A nomogram for predicting mortality risk within 30 days in sepsis patients admitted in the emergency department: A retrospective analysis

“…Thus, there have not been prediction model to evaluate the short-term prognosis of sepsis patients effectively who are admitted at emergency department. To this end, our aim was to establish a model to evaluate the mortality risk among the sepsis patients who are admitted at emergency department, displayed as a nomogram graph, which could provide a more understandable outcome measure and have been broadly adopted [ 21 , 22 ].…”