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Development and Validation of a Nomogram Based on Metabolic Risk Score for Assessing Lymphovascular Space Invasion in Patients with Endometrial Cancer

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  • Jingyuan Wang

    (Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, China
    These authors contributed equally to this work.)

  • Xingchen Li

    (Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, China
    These authors contributed equally to this work.)

  • Xiao Yang

    (Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, China)

  • Jianliu Wang

    (Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing 100044, China)

Abstract

Objective: This study assessed the predictive value of the metabolic risk score (MRS) for lymphovascular space invasion (LVSI) in endometrial cancer (EC) patients. Methods: We included 1076 patients who were diagnosed with EC between January 2006 and December 2020 in Peking University People’s Hospital. All patients were randomly divided into the training and validation cohorts in a ratio of 2:1. Data on clinicopathological indicators were collected. Univariable and multivariable logistic regression analysis was used to define candidate factors for LVSI. A backward stepwise selection was then used to select variables for inclusion in a nomogram. The performance of the nomogram was evaluated by discrimination, calibration, and clinical usefulness. Results: Independent predictors of LVSI included differentiation grades (G2: OR = 1.800, 95% CI: 1.050–3.070, p = 0.032) (G3: OR = 3.49, 95% CI: 1.870–6.520, p < 0.001), histology (OR = 2.723, 95% CI: 1.370–5.415, p = 0.004), MI (OR = 4.286, 95% CI: 2.663–6.896, p < 0.001), and MRS (OR = 1.124, 95% CI: 1.067–1.185, p < 0.001) in the training cohort. A nomogram was established to predict a patient’s probability of developing LVSI based on these factors. The ROC curve analysis showed that an MRS-based nomogram significantly improved the efficiency of diagnosing LVSI compared with the nomogram based on clinicopathological factors ( p = 0.0376 and p = 0.0386 in the training and validation cohort, respectively). Subsequently, the calibration plot showed a favorable consistency in both groups. Moreover, we conducted a decision curve analysis, showing the great clinical benefit obtained from the application of our nomogram. However, our study faced several limitations. Further external validation and a larger sample size are needed in future studies. Conclusion: MRS-based nomograms are useful for predicting LVSI in patients with EC and may facilitate better clinical decision-making.

Suggested Citation

  • Jingyuan Wang & Xingchen Li & Xiao Yang & Jianliu Wang, 2022. "Development and Validation of a Nomogram Based on Metabolic Risk Score for Assessing Lymphovascular Space Invasion in Patients with Endometrial Cancer," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15654-:d:983583
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    References listed on IDEAS

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    1. Takafumi Watanabe & Reiko Honma & Manabu Kojima & Shinji Nomura & Shigenori Furukawa & Shu Soeda & Shinya Watanabe & Keiya Fujimori, 2019. "Prediction of lymphovascular space invasion in endometrial cancer using the 55-gene signature selected by DNA microarray analysis," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-10, September.
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