Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor

PurposeTo develop and validate nomograms for pre-treatment prediction of malignant histology (MH) and unfavorable pathology (UP) in patients with endophytic renal tumors (ERTs).MethodsWe retrospectively reviewed the clinical information of 3245 patients with ERTs accepted surgical treatment in our c...

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Main Authors: Xinxi Deng, Xiaoqiang Liu, Bing Hu, Ming Jiang, Ke Zhu, Jianqiang Nie, Taobin Liu, Luyao Chen, Wen Deng, Bin Fu, Situ Xiong
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.964048/full
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author Xinxi Deng
Xinxi Deng
Xiaoqiang Liu
Xiaoqiang Liu
Bing Hu
Bing Hu
Ming Jiang
Ming Jiang
Ke Zhu
Ke Zhu
Jianqiang Nie
Jianqiang Nie
Taobin Liu
Taobin Liu
Luyao Chen
Luyao Chen
Wen Deng
Wen Deng
Bin Fu
Bin Fu
Situ Xiong
Situ Xiong
author_facet Xinxi Deng
Xinxi Deng
Xiaoqiang Liu
Xiaoqiang Liu
Bing Hu
Bing Hu
Ming Jiang
Ming Jiang
Ke Zhu
Ke Zhu
Jianqiang Nie
Jianqiang Nie
Taobin Liu
Taobin Liu
Luyao Chen
Luyao Chen
Wen Deng
Wen Deng
Bin Fu
Bin Fu
Situ Xiong
Situ Xiong
author_sort Xinxi Deng
collection DOAJ
description PurposeTo develop and validate nomograms for pre-treatment prediction of malignant histology (MH) and unfavorable pathology (UP) in patients with endophytic renal tumors (ERTs).MethodsWe retrospectively reviewed the clinical information of 3245 patients with ERTs accepted surgical treatment in our center. Eventually, 333 eligible patients were included and randomly enrolled into training and testing sets in a ratio of 7:3. We performed univariable and multivariable logistic regression analyses to determine the independent risk factors of MH and UP in the training set and developed the pathological diagnostic models of MH and UP. The optimal model was used to construct a nomogram for MH and UP. The area under the receiver operating characteristics (ROC) curves (AUC), calibration curves and decision curve analyses (DCA) were used to evaluate the predictive performance of models.ResultsOverall, 172 patients with MH and 50 patients with UP were enrolled in the training set; and 74 patients with MH and 21 patients with UP were enrolled in the validation set. Sex, neutrophil-to-lymphocyte ratio (NLR), R score, N score and R.E.N.A.L. score were the independent predictors of MH; and BMI, NLR, tumor size and R score were the independent predictors of UP. Single-variable and multiple-variable models were constructed based on these independent predictors. Among these predictive models, the malignant histology-risk nomogram consisted of sex, NLR, R score and N score and the unfavorable pathology-risk nomogram consisted of BMI, NLR and R score performed an optimal predictive performance, which reflected in the highest AUC (0.842 and 0.808, respectively), the favorable calibration curves and the best clinical net benefit. In addition, if demographic characteristics and laboratory tests were excluded from the nomograms, only the components of the R.E.N.A.L. Nephrometry Score system were included to predict MH and UP, the AUC decreased to 0.781 and 0.660, respectively (P=0.001 and 0.013, respectively).ConclusionIn our study, the pathological diagnostic models for predicting malignant and aggressive histological features for patients with ERTs showed outstanding predictive performance and convenience. The use of the models can greatly assist urologists in individualizing the management of their patients.
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spelling doaj.art-30dab687f9704c6db4ea0086a47267632022-12-22T04:05:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.964048964048Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumorXinxi Deng0Xinxi Deng1Xiaoqiang Liu2Xiaoqiang Liu3Bing Hu4Bing Hu5Ming Jiang6Ming Jiang7Ke Zhu8Ke Zhu9Jianqiang Nie10Jianqiang Nie11Taobin Liu12Taobin Liu13Luyao Chen14Luyao Chen15Wen Deng16Wen Deng17Bin Fu18Bin Fu19Situ Xiong20Situ Xiong21Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Urology, Jiu Jiang NO.1 People’s Hospital, Jiujiang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaPurposeTo develop and validate nomograms for pre-treatment prediction of malignant histology (MH) and unfavorable pathology (UP) in patients with endophytic renal tumors (ERTs).MethodsWe retrospectively reviewed the clinical information of 3245 patients with ERTs accepted surgical treatment in our center. Eventually, 333 eligible patients were included and randomly enrolled into training and testing sets in a ratio of 7:3. We performed univariable and multivariable logistic regression analyses to determine the independent risk factors of MH and UP in the training set and developed the pathological diagnostic models of MH and UP. The optimal model was used to construct a nomogram for MH and UP. The area under the receiver operating characteristics (ROC) curves (AUC), calibration curves and decision curve analyses (DCA) were used to evaluate the predictive performance of models.ResultsOverall, 172 patients with MH and 50 patients with UP were enrolled in the training set; and 74 patients with MH and 21 patients with UP were enrolled in the validation set. Sex, neutrophil-to-lymphocyte ratio (NLR), R score, N score and R.E.N.A.L. score were the independent predictors of MH; and BMI, NLR, tumor size and R score were the independent predictors of UP. Single-variable and multiple-variable models were constructed based on these independent predictors. Among these predictive models, the malignant histology-risk nomogram consisted of sex, NLR, R score and N score and the unfavorable pathology-risk nomogram consisted of BMI, NLR and R score performed an optimal predictive performance, which reflected in the highest AUC (0.842 and 0.808, respectively), the favorable calibration curves and the best clinical net benefit. In addition, if demographic characteristics and laboratory tests were excluded from the nomograms, only the components of the R.E.N.A.L. Nephrometry Score system were included to predict MH and UP, the AUC decreased to 0.781 and 0.660, respectively (P=0.001 and 0.013, respectively).ConclusionIn our study, the pathological diagnostic models for predicting malignant and aggressive histological features for patients with ERTs showed outstanding predictive performance and convenience. The use of the models can greatly assist urologists in individualizing the management of their patients.https://www.frontiersin.org/articles/10.3389/fonc.2022.964048/fullendophytic renal tumorpathological featuremalignant histologyunfavorable pathologythe R.E.N.A.L. Nephrometry Scorepathological diagnostic model
spellingShingle Xinxi Deng
Xinxi Deng
Xiaoqiang Liu
Xiaoqiang Liu
Bing Hu
Bing Hu
Ming Jiang
Ming Jiang
Ke Zhu
Ke Zhu
Jianqiang Nie
Jianqiang Nie
Taobin Liu
Taobin Liu
Luyao Chen
Luyao Chen
Wen Deng
Wen Deng
Bin Fu
Bin Fu
Situ Xiong
Situ Xiong
Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
Frontiers in Oncology
endophytic renal tumor
pathological feature
malignant histology
unfavorable pathology
the R.E.N.A.L. Nephrometry Score
pathological diagnostic model
title Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
title_full Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
title_fullStr Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
title_full_unstemmed Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
title_short Pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
title_sort pathological diagnostic nomograms for predicting malignant histology and unfavorable pathology in patients with endophytic renal tumor
topic endophytic renal tumor
pathological feature
malignant histology
unfavorable pathology
the R.E.N.A.L. Nephrometry Score
pathological diagnostic model
url https://www.frontiersin.org/articles/10.3389/fonc.2022.964048/full
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