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学科主题: 临床医学
题名:
Development and Validation of a Clinical Prediction Model for N2 Lymph Node Metastasis in Non-Small Cell Lung Cancer
作者: Chen, Kezhong; Yang, Fang; Jiang, Guanchao; Li, Jianfeng; Wang, Jun
刊名: ANNALS OF THORACIC SURGERY
发表日期: 2013-11-01
DOI: 10.1016/j.athoracsur.2013.06.038
卷: 96, 期:5, 页:1761-1768
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Respiratory System ; Surgery
研究领域[WOS]: Cardiovascular System & Cardiology ; Respiratory System ; Surgery
关键词[WOS]: POSITRON-EMISSION-TOMOGRAPHY ; COMPUTED-TOMOGRAPHY ; RISK-FACTORS ; STAGE ; DISEASE ; MEDIASTINOSCOPY ; PROBABILITY ; PATTERN ; PET/CT ; SIZE
英文摘要:

Background. The true incidence of occult N2 lymph node metastasis in patients with clinical N0 non-small cell lung cancer (NSCLC) remains controversial. Estimation of the probability of N2 lymph node metastasis can assist physicians when making diagnosis and treatment decisions.

Methods. We reviewed the medical records of 605 patients (group A) and 211 patients (group B) with computed tomography-defined N0 NSCLC that had an exact tumor-node-metastasis stage after surgery. Logistic regression analysis of group A′s clinical characteristics was used to estimate the independent predictors of N2 lymph node metastasis. A prediction model was then built and internally validated by using cross validation and externally validated in group B. The model was also compared with 2 previously described models.

Results. We identified 4 independent predictors of N2 disease: a younger age; larger tumor size; central tumor location; and adenocarcinoma or adenosquamous carcinoma pathology. The model showed good calibration (Hosmer-Lemeshow test: p = 0.96) with an area under the receiver operating characteristic curve (AUC) of 0.756 (95% confidence interval, 0.699 to 0.813). The AUC of our model was better than those of the other models when validated with independent data.

Conclusions. Our prediction model estimated the pretest probability of N2 disease in computed tomography-defined N0 NSCLC and was more accurate than the existing models. Use of our model can be of assistance when making clinical decisions about invasive or expensive mediastinal staging procedures. (C) 2013 by The Society of Thoracic Surgeons

语种: 英语
WOS记录号: WOS:000326375700042
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55620
Appears in Collections:北京大学第二临床医学院_胸外科_期刊论文

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作者单位: Peking Univ Peoples Hosp, Dept Thorac Surg, Beijing 100044, Peoples R China

Recommended Citation:
Chen, Kezhong,Yang, Fang,Jiang, Guanchao,et al. Development and Validation of a Clinical Prediction Model for N2 Lymph Node Metastasis in Non-Small Cell Lung Cancer[J]. ANNALS OF THORACIC SURGERY,2013,96(5):1761-1768.
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