Development and Validation of a Biopsy Decision Model for Nasopharyngeal Carcinoma Based on Serological Markers and Endoscopic Features
An observational study combines retrospective and prospective cohorts to develop, validate, and compare models based on Epstein-Barr virus (EBV)-related blood biomarkers alone, nasopharyngeal endoscopic scores alone, and their combination to support biopsy decisions for nasopharyngeal carcinoma (NPC). Existing clinical data will be analyzed retrospectively for model development and internal validation. Data from participants undergoing nasopharyngeal endoscopy and clinically indicated nasopharyngeal biopsy at participating centers will be collected prospectively for external validation. The study will assess the models' diagnostic performance and potential value in identifying individuals who may benefit from biopsy and reducing unnecessary biopsies. Clinical decisions will follow routine practice.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
The study includes a retrospective cohort for model development and internal validation and a prospective cohort for external validation at participating centers. Models based on EBV-related blood biomarkers alone, nasopharyngeal endoscopic scores alone, and their combination will be developed, validated, and compared.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Mingfang Ji
- Telefonnummer: 86-0760-89880417
- E-mail: jmftbh@sina.com
Studiesteder
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Guangdong
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Zhongshan, Guangdong, Kina, 528403
- Zhongshan City People's Hospital
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Kontakt:
- Mingfang Ji
- Telefonnummer: 86-0760-89880417
- E-mail: jmftbh@sina.com
-
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Guangxi
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Nanning, Guangxi, Kina, 530022
- People's Hospital of Guangxi Zhuang Autonomous Region
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Kontakt:
- Shenhong Qu, MD PhD
- Telefonnummer: 86 15676172501
- E-mail: xhh2501@126.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
The study population comprises individuals undergoing nasopharyngeal endoscopy and clinically indicated nasopharyngeal biopsy for NPC risk assessment or suspected NPC at participating hospitals. The retrospective cohort will use existing clinical records, while the prospective cohort will enroll eligible individuals consecutively.
Beskrivelse
Inclusion Criteria:
- Voluntarily agree to participate in the study and provide written informed consent;
- Be aged ≥18 years;
- Have available EBV-related serological test results or be able to provide blood samples for the relevant testing;
- Undergo nasopharyngeal endoscopy for nasopharyngeal carcinoma risk assessment or suspected nasopharyngeal carcinoma;
- Undergo nasopharyngeal biopsy as part of routine clinical care.
Exclusion Criteria:
- Previous confirmed diagnosis of nasopharyngeal carcinoma or prior treatment for nasopharyngeal carcinoma;
- Receipt of immunosuppressive therapy or other treatments that may affect serum antibody levels within the past 6 months;
- Severe organ dysfunction, including decompensated heart failure, respiratory failure, decompensated liver cirrhosis, or renal failure.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Observationsmodeller: COHORT
- Tidsperspektiver: OTHER
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Training Cohort
Participants selected from existing clinical records who underwent nasopharyngeal endoscopy and clinically indicated nasopharyngeal biopsy for NPC risk assessment or suspected NPC. EBV-related blood biomarker results, nasopharyngeal endoscopic scores, and pathological diagnoses will be analyzed for model development. |
EBV-related blood biomarkers, including P85-Ab, EBNA1-IgA, and VCA-IgA, among others, will be evaluated together with nasopharyngeal endoscopic scores to support biopsy decisions for nasopharyngeal carcinoma. Biopsy and treatment decisions will follow routine clinical practice. |
|
Internal Validation Cohort
Participants from the retrospective study population who are not included in the training cohort. Their EBV-related blood biomarker results, nasopharyngeal endoscopic scores, and pathological diagnoses will be used for internal validation of the developed models. |
EBV-related blood biomarkers, including P85-Ab, EBNA1-IgA, and VCA-IgA, among others, will be evaluated together with nasopharyngeal endoscopic scores to support biopsy decisions for nasopharyngeal carcinoma. Biopsy and treatment decisions will follow routine clinical practice. |
|
External Validation Cohort
Participants undergoing nasopharyngeal endoscopy and clinically indicated nasopharyngeal biopsy at participating centers will be enrolled prospectively. EBV-related blood biomarker results, nasopharyngeal endoscopic scores, and pathological diagnoses from clinically indicated biopsies will be collected for external validation of the developed models. Clinical decisions will follow routine practice. |
EBV-related blood biomarkers, including P85-Ab, EBNA1-IgA, and VCA-IgA, among others, will be evaluated together with nasopharyngeal endoscopic scores to support biopsy decisions for nasopharyngeal carcinoma. Biopsy and treatment decisions will follow routine clinical practice. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Sensitivity of serological, endoscopic, and combined models at prespecified risk thresholds
Tidsramme: Baseline
|
Sensitivity and corresponding 95% confidence intervals will be assessed and compared across models based on EBV-related blood biomarkers alone, nasopharyngeal endoscopic scores alone, and their combination at prespecified risk thresholds, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
|
Specificity of serological, endoscopic, and combined models at prespecified risk thresholds
Tidsramme: Baseline
|
Specificity and corresponding 95% confidence intervals will be assessed and compared across models based on EBV-related blood biomarkers alone, nasopharyngeal endoscopic scores alone, and their combination at prespecified risk thresholds, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Area under the receiver operating characteristic curve (AUC) of serological, endoscopic, and combined models
Tidsramme: Baseline
|
AUCs and corresponding 95% confidence intervals will be assessed and compared across models based on EBV-related blood biomarkers alone, nasopharyngeal endoscopic scores alone, and their combination, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
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Calibration intercept of serological, endoscopic, and combined models
Tidsramme: Baseline
|
The calibration intercept will be calculated for each model using predicted probabilities and histopathological diagnoses, separately in the internal validation cohort and the prospective external validation cohort. An intercept of 0 indicates ideal calibration in this respect. |
Baseline
|
|
Calibration slope of serological, endoscopic, and combined models
Tidsramme: Baseline
|
The calibration slope will be calculated for each model using predicted probabilities and histopathological diagnoses, separately in the internal validation cohort and the prospective external validation cohort. A slope of 1 indicates ideal calibration in this respect. |
Baseline
|
|
Brier score of serological, endoscopic, and combined models
Tidsramme: Baseline
|
The Brier score will be calculated for each model as the mean squared difference between predicted probabilities and histopathological outcomes, coded as 1 for nasopharyngeal carcinoma and 0 otherwise, separately in the internal validation cohort and the prospective external validation cohort. Scores range from 0 to 1, with lower scores indicating better overall predictive accuracy. |
Baseline
|
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Positive predictive value of serological, endoscopic, and combined models at prespecified risk thresholds
Tidsramme: Baseline
|
Positive predictive values and corresponding 95% confidence intervals will be calculated for each model at prespecified risk thresholds, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
|
Negative predictive value of serological, endoscopic, and combined models at prespecified risk thresholds
Tidsramme: Baseline
|
Negative predictive values and corresponding 95% confidence intervals will be calculated for each model at prespecified risk thresholds, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
|
Net benefit of model-based biopsy strategies
Tidsramme: Baseline
|
Decision curve analysis will be used to assess and compare the net benefit of biopsy strategies based on serological, endoscopic, and combined models with biopsy-all and biopsy-none strategies across risk thresholds, separately in the internal validation cohort and the prospective external validation cohort, using nasopharyngeal biopsy histopathology as the reference standard. |
Baseline
|
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Potential percentage of biopsies avoided using model-based strategies at prespecified risk thresholds
Tidsramme: Baseline
|
For each serological, endoscopic, and combined model, the potential percentage of biopsies avoided will be calculated as the percentage of all evaluated participants undergoing biopsy whose predicted risk is below the prespecified threshold. This represents the potential reduction in biopsies relative to a biopsy-all strategy and will be assessed separately in the internal validation cohort and the prospective external validation cohort. |
Baseline
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Stomatognatiske sygdomme
- Neoplasmer efter sted
- Neoplasmer
- Neoplasmer efter histologisk type
- Neoplasmer i hoved og hals
- Neoplasmer, kirtel og epitel
- Karcinom
- Otorhinolaryngologiske sygdomme
- Pharyngeale neoplasmer
- Otorhinolaryngologiske neoplasmer
- Nasopharyngeale sygdomme
- Pharyngeale sygdomme
- Nasopharyngeale neoplasmer
- Nasopharyngealt karcinom
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- NPC-2026-biopsymodel
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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