Risk assessment and prediction of occult uterine sarcoma in patients with presumed uterine fibroids before high-intensity focused ultrasound treatment.

IF 3 3区 医学 Q2 ONCOLOGY International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-07-31 DOI:10.1080/02656736.2024.2385600
Qian Wang, Zhenjiang Lin, Xiaogang Zhu, Yangyang Wang, Ying Zhang, Min He, Lian Zhang
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Abstract

Objective: To develop a diagnostic model for predicting occult uterine sarcoma in patients with presumed uterine fibroids.

Materials and methods: We retrospectively reviewed 41631 patients with presumed uterine fibroids who presented for HIFU treatment in 13 hospitals between November 2008 and October 2023. Of these patients, 27 with occult uterine sarcoma and 54 with uterine fibroids were enrolled. Univariate analysis and multivariate logistics regression analysis were used to determine the independent risk factors for the diagnosis of occult uterine sarcoma. A prediction model was constructed based on the coefficients of the risk factors.

Results: The multivariate analysis revealed abnormal vaginal bleeding, ill-defined boundary of tumor, hyperintensity on T2WI, and central unenhanced areas as independent risk factors. A scoring system was created to assess for occult uterine sarcoma risk. The score for abnormal vaginal bleeding was 56. The score for ill-defined lesion boundary was 90. The scores for lesions with hypointensity, isointensity signal/heterogeneous signal intensity, and hyperintensity on T2WI were 0, 42, and 93, respectively. The scores for lesions without enhancement on the mass margin, uniform enhancement of tumor, and no enhancement in the center of tumor were 0, 20, and 100, respectively. Patients with a higher total score implied a higher likelihood of a diagnosis of occult uterine sarcoma than that of patients with a lower score. The established model showed good predictive efficacy.

Conclusions: Our results demonstrated that the diagnostic prediction model can be used to evaluate the risk of uterine sarcoma in patients with presumed uterine fibroids.

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高强度聚焦超声治疗前对子宫肌瘤假定患者隐匿性子宫肉瘤的风险评估和预测。
目的:建立一个诊断模型,用于预测子宫肌瘤患者的隐匿性子宫肉瘤:建立一个诊断模型,用于预测假定子宫肌瘤患者的隐匿性子宫肉瘤:我们回顾性研究了 2008 年 11 月至 2023 年 10 月期间在 13 家医院接受 HIFU 治疗的 41631 例子宫肌瘤患者。其中,27 例为隐匿性子宫肉瘤患者,54 例为子宫肌瘤患者。采用单变量分析和多变量物流回归分析来确定隐匿性子宫肉瘤诊断的独立风险因素。根据风险因素的系数建立了预测模型:多变量分析显示,异常阴道出血、肿瘤边界不清晰、T2WI高密度和中心未增强区是独立的风险因素。我们建立了一个评分系统来评估隐匿性子宫肉瘤的风险。异常阴道出血的评分为 56 分。病灶边界不清的评分为 90 分。T2WI 低密度、等密度信号/异质信号强度和高密度病变的得分分别为 0、42 和 93 分。肿块边缘无强化、肿瘤均匀强化和肿瘤中心无强化的病灶得分分别为 0、20 和 100。总分较高的患者被诊断为隐匿性子宫肉瘤的可能性高于总分较低的患者。所建立的模型具有良好的预测效果:我们的研究结果表明,诊断预测模型可用于评估子宫肌瘤患者罹患子宫肉瘤的风险。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
期刊最新文献
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