PT  - JOURNAL ARTICLE
AU  - Rong-Zhen Luo
AU  - Xia Yang
AU  - Shi-Wen Zhang
AU  - Li-Li Liu
TI  - Establishment and validation of prognostic nomograms integrating histopathological features in patients with endocervical adenocarcinoma
AID  - 10.1136/jcp-2021-208064
DP  - 2023 Nov 01
TA  - Journal of Clinical Pathology
PG  - 747--752
VI  - 76
IP  - 11
4099  - http://jcp.bmj.com/content/76/11/747.short
4100  - http://jcp.bmj.com/content/76/11/747.full
SO  - J Clin Pathol2023 Nov 01; 76
AB  - Aims To develop and verify pathological models using pathological features basing on HE images to predict survival invasive endocervical adenocarcinoma (ECA) postoperatively.Methods There are 289 ECA patients were classified into training and validation cohort. A histological signature was produced in 191 patients and verified in the validation groups. Histological models combining the histological features were built, proving the incremental value of our model to the traditional staging system for individualised prognosis estimation.Results Our model included five chosen histological characteristics and was significantly related to overall survival (OS). Our model had AUC of 0.862 and 0.955, 0.891 and 0.801 in prognosticating 3-year and 5 year OS in the training and validation cohort, respectively. In training cohorts, our model had better performance for evaluation of OS (C-index: 0.832; 95% CI 0.751 to 0.913) than International Federation of Gynecology and Obstetrics (FIGO) staging system (C-index: 0.648; 95% CI 0.542 to 0.753) and treatment (C-index: 0.687; 95% CI 0.605 to 0.769), with advanced efficiency of the classification of survival outcomes. Furthermore, in both cohorts, a risk stratification system was built that was able to precisely stratify stage I and II ECA patients into high-risk and low-risk subpopulation with significantly different prognosis.Conclusions A nomogram with five histological signatures had better performance in OS prediction compared with traditional staging systems in ECAs, which might enable a step forward to precision medicine.All data relevant to the study are included in the article or uploaded as online supplemental information.