Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions
We aimed to develop an improved version of the diagnostic model predicting the risk of malignant esophageal lesions in opportunistic screening and validate it in external populations. The development set involved 10,595 outpatients receiving endoscopy from a hospital in Hua County, a high-risk regio...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/23/5945 |
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| author | Zhen Liu Hongchen Zheng Mengfei Liu Yujie He Yun Chen Ping Ji Zhengyu Fang Ping Xiao Fenglei Li Chuanhai Guo Weihua Yin Yaqi Pan Zhonghu He Yang Ke |
| author_facet | Zhen Liu Hongchen Zheng Mengfei Liu Yujie He Yun Chen Ping Ji Zhengyu Fang Ping Xiao Fenglei Li Chuanhai Guo Weihua Yin Yaqi Pan Zhonghu He Yang Ke |
| author_sort | Zhen Liu |
| collection | DOAJ |
| description | We aimed to develop an improved version of the diagnostic model predicting the risk of malignant esophageal lesions in opportunistic screening and validate it in external populations. The development set involved 10,595 outpatients receiving endoscopy from a hospital in Hua County, a high-risk region for esophageal squamous cell carcinoma in northern China. Validation set A enrolled 9453 outpatients receiving endoscopy in a non-high-risk region in southern China. Validation set B involved 17,511 residents in Hua County. The improved diagnostic model consisted of seven predictors including age, gender, family history of esophageal squamous cell carcinoma, smoking, body mass index, dysphagia, and retrosternal pain, with an area under the receiver operating characteristic curve (AUC) of 0.860 (95% confidence interval: 0.835–0.886) in the development set. Ideal discrimination ability was achieved in external validations (AUC <sub>validation set A</sub>: 0.892, 95% confidence interval: 0.858–0.926; AUC <sub>validation set B</sub>: 0.799, 95% confidence interval: 0.705–0.894). This improved model also markedly increased the detection rate of malignant esophageal lesions compared with universal screening, demonstrating great potential for use in opportunistic screening of malignant esophageal lesions in heterogeneous populations. |
| first_indexed | 2024-03-09T17:51:54Z |
| format | Article |
| id | doaj.art-fefc4e1d0f01485b8b55ec13145858b2 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T17:51:54Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-fefc4e1d0f01485b8b55ec13145858b22023-11-24T10:41:15ZengMDPI AGCancers2072-66942022-11-011423594510.3390/cancers14235945Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal LesionsZhen Liu0Hongchen Zheng1Mengfei Liu2Yujie He3Yun Chen4Ping Ji5Zhengyu Fang6Ping Xiao7Fenglei Li8Chuanhai Guo9Weihua Yin10Yaqi Pan11Zhonghu He12Yang Ke13Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaEndoscopy Center, Hua County People’s Hospital, Hua County 456483, ChinaDepartment of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518034, ChinaClinical Research Institute, Shenzhen Peking University-Hong Kong University of Science and Technology Medical Center, Shenzhen 518034, ChinaClinical Research Institute, Shenzhen Peking University-Hong Kong University of Science and Technology Medical Center, Shenzhen 518034, ChinaClinical Research Institute, Shenzhen Peking University-Hong Kong University of Science and Technology Medical Center, Shenzhen 518034, ChinaHua County People’s Hospital, Hua County 456483, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaDepartment of Pathology, Peking University Shenzhen Hospital, Shenzhen 518034, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaWe aimed to develop an improved version of the diagnostic model predicting the risk of malignant esophageal lesions in opportunistic screening and validate it in external populations. The development set involved 10,595 outpatients receiving endoscopy from a hospital in Hua County, a high-risk region for esophageal squamous cell carcinoma in northern China. Validation set A enrolled 9453 outpatients receiving endoscopy in a non-high-risk region in southern China. Validation set B involved 17,511 residents in Hua County. The improved diagnostic model consisted of seven predictors including age, gender, family history of esophageal squamous cell carcinoma, smoking, body mass index, dysphagia, and retrosternal pain, with an area under the receiver operating characteristic curve (AUC) of 0.860 (95% confidence interval: 0.835–0.886) in the development set. Ideal discrimination ability was achieved in external validations (AUC <sub>validation set A</sub>: 0.892, 95% confidence interval: 0.858–0.926; AUC <sub>validation set B</sub>: 0.799, 95% confidence interval: 0.705–0.894). This improved model also markedly increased the detection rate of malignant esophageal lesions compared with universal screening, demonstrating great potential for use in opportunistic screening of malignant esophageal lesions in heterogeneous populations.https://www.mdpi.com/2072-6694/14/23/5945esophageal squamous cell carcinomaopportunistic screeningdiagnostic modelmodel updatingexternal validation |
| spellingShingle | Zhen Liu Hongchen Zheng Mengfei Liu Yujie He Yun Chen Ping Ji Zhengyu Fang Ping Xiao Fenglei Li Chuanhai Guo Weihua Yin Yaqi Pan Zhonghu He Yang Ke Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions Cancers esophageal squamous cell carcinoma opportunistic screening diagnostic model model updating external validation |
| title | Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions |
| title_full | Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions |
| title_fullStr | Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions |
| title_full_unstemmed | Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions |
| title_short | Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions |
| title_sort | development and external validation of an improved version of the diagnostic model for opportunistic screening of malignant esophageal lesions |
| topic | esophageal squamous cell carcinoma opportunistic screening diagnostic model model updating external validation |
| url | https://www.mdpi.com/2072-6694/14/23/5945 |
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