Establishment and validation of a predictive nomogram for the risk of premalignant lesions in children with choledochal cyst

作者：Ruyue Gao, Meng Ke, Jie Shi, Yandong Zhang, Jizhen Zou, Mei Diao, Long Li · 发表于：Frontiers in Pediatrics · 年份：2023 · DOI：10.3389/fped.2023.1108788 · 被引用次数：8 · 研究领域：Pediatric Hepatobiliary Diseases and Treatments、Gallbladder and Bile Duct Disorders、Pancreatitis Pathology and Treatment

Background Choledochal cyst (CDC) increases the risk (2.5%–30%) of malignancy. Metaplasia and dysplasia have been recognized as premalignant lesions among CDCs. This study aimed to evaluate the risk factors of metaplasia and dysplasia in CDC children. Methods Two hundred and ten CDC children who underwent cyst excision and Roux-en-Y hepaticojejunostomy at our institution between July 2020 and November 2021 were included and randomly divided into the training set and validation set. Univariate and multivariate logistic regression analysis were used to identify independent risk factors of premalignant lesions in the training set and build a predictive nomogram. The performance and discriminatory abilities of the nomogram were further assessed and validated in the validation set. Results Of the 210 CDC children, 78 (37.1%) patients developed premalignant lesions. Age (OR, 1.011, 95%CI, 1.000–1.022, P = 0.046), symptoms duration (OR, 1.021, 95%CI, 1.001–1.042, P = 0.036), cyst diameter (OR, 1.737, 95%CI, 1.328–2.273, P < 0.001), recurrent attacks of biliary pancreatitis (OR, 3.653, 95%CI, 1.205–11.076, P = 0.022), and biliary operation history (OR, 5.860, 95%CI, 1.268–27.084, P = 0.024) were identified as independent risk factors. Based on these predictors, a predictive nomogram was generated. The AUC of the nomogram was 0.873 in the training set and 0.793 in the validation set, indicating that it was robust and well calibrated. Conclusions A novel nomogram to the individu...