为了确定将血清 microRNA 与蛋白质生物标志物和元数据相结合的多模式测定是否可以改善附件肿块的分类评估。对 468 名训练受试者（191 名癌症病例和 277 名良性附件肿块对照或健康对照）的血清样本进行了 7 种蛋白质生物标志物和 180 种蛋白质生物标志物分析。 miRNA。将循环分析物数据与年龄和绝经状态（元数据）结合到神经网络模型中，以将样本分类为病例或对照。具有十倍交叉验证的正向回归最小化了模型的维数，同时最大化了病例和对照之间的线性分离。使用内部（44 个病例和 56 个对照）和外部验证集（51 个病例和 59 个对照）进行模型验证。总研究人群包括 678 名受试者，其中 286 名病例和 392 名对照。总体而言，290 名（43%）受试者处于绝经前状态。一组 10 个 miRNA 与蛋白质和元数据特征相结合可提供最佳性能。与 miRNA 相比，组合模型改善了内部（AUC = 0.9；95% CI 0.81-0.95）和外部验证集（AUC = 0.95；95% CI 0.90-0.98）的接收者操作员特征曲线下面积 (ROC AUC)单独或蛋白质加元数据（不含 miRNA）。在外部验证中，组合模型的总体敏感性为 92%，特异性为 80%，对早期和晚期癌症的敏感性分别为 80% 和 100%，其中对早期浆液性卵巢癌的敏感性为 78%，对早期浆液性卵巢癌的敏感性为 82%用于早期非浆液性癌症。将 miRNA 与蛋白质生物标志物、年龄和绝经状态相结合的多模式测定可改善附件肿块的手术分类。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

To determine whether a multimodal assay combining serum microRNA with protein biomarkers and metadata improves triage assessment of an adnexal mass.Serum samples from 468 training subjects (191 cancer cases and 277 benign adnexal mass controls or healthy controls) were analyzed for seven protein biomarkers and 180 miRNA. Circulating analyte data were combined with age and menopausal status (metadata) into a neural network model to classify samples as cases or controls. Forward regression with ten-fold cross-validation minimized the dimensionality of the model while maximizing linear separation between cases and controls. Model validation proceeded using both internal (44 cases and 56 controls) and external validation sets (51 cases and 59 controls).The total study population comprised 678 subjects, including 286 cases and 392 controls. Overall, 290 (43%) of the subjects were premenopausal. A panel of 10 miRNA delivered optimal performance when combined with protein and metadata features. The combined model improved the Receiver Operator Characteristic Area Under the Curve (ROC AUC) on the internal (AUC = 0.9; 95% CI 0.81-0.95) and external validation sets (AUC = 0.95; 95% CI 0.90-0.98) compared to miRNA alone or proteins plus metadata (without miRNA). On external validation, the combined model offered 92% sensitivity at 80% specificity overall, with 80% and 100% sensitivity for early and late-stage cancers, respectively, including 78% sensitivity for early-stage, serous ovarian cancers and 82% sensitivity for early-stage, non-serous cancers.A multimodal assay combining miRNA with protein biomarkers, age, and menopausal status improves surgical triage of an adnexal mass.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.