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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Oncology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1407120

Nomogram for Predicting Testicular Yolk Sac Tumor in Children Based on Age, Alpha-Fetoprotein, and Ultrasonography

Provisionally accepted
Huan Yu Huan Yu 1Hui Wang Hui Wang 1Yichen Huang Yichen Huang 1*Huiyong Hu Huiyong Hu 2YUE ZHANG YUE ZHANG 3Min Wu Min Wu 1Yiqing Lv Yiqing Lv 1Yan Chen Yan Chen 1Lijun Zhou Lijun Zhou 1Yan Liang Yan Liang 1Huizhen Sun Huizhen Sun 1Xiaoling Lin Xiaoling Lin 1Hua Xie Hua Xie 1Fang Chen Fang Chen 1
  • 1 Department of Urology, Shanghai Children's Hospital, Shanghai, China
  • 2 Department of Ultrasound, Shanghai Children's Hospital, Shanghai, Shanghai Municipality, China
  • 3 School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Objective: To establish a predictive model for distinguishing testicular benign or yolk sac tumors in children. Methods: We retrospectively analyzed data for 119 consecutive patients with unilateral testicular tumors treated at a single institution from June 2014 to July 2020. The patients were divided into the benign (n=90) and yolk sac (n=29) tumor groups based on the pathological diagnosis. We recorded patient age, serum markers (serum alpha-fetoprotein (AFP), human chorionic gonadotropin), and tumor ultrasonic findings (maximum diameter, ultrasonic echo, blood flow signal). Predictive factors were identified using descriptive statistical methods. A nomogram was established for preoperative prediction. An additional 46 patients were used as a validation cohort to verify the model. Results: Patients with testicular yolk sac tumors were younger (median age: 14.0 vs. 34.0 months, P=0.001) and had a higher incidence of elevated AFP levels (93.1% vs. 2.2%, P<0.001). Ultrasonography indicated that testicular yolk sac tumors tended to have larger maximum diameters (26.5±11.3 vs. 16.6±9.2 cm, P<0.001), a higher proportion of hypoechoic masses (44.8% vs. 8.9%, P<0.001), and a higher incidence of masses with strong blood flow signals (93.1% vs. 5.6%, P<0.001). A nomogram based on age, AFP levels, and ultrasound blood flow signals effectively predicted the probability of yolk sac tumor in children, with an accuracy of 0.98 (95% confidence interval: 0.984–1.003). The Brier score of the nomogram was 0.0002. Conclusion: A nomogram based on age, AFP levels, and ultrasound blood flow signals can effectively predict the probability of testicular yolk sac tumor preoperatively, aiding in clinical decision-making and patient counseling.

    Keywords: testicular tumor, AFP, Ultrasonography, Children, nomogram

    Received: 26 Mar 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Yu, Wang, Huang, Hu, ZHANG, Wu, Lv, Chen, Zhou, Liang, Sun, Lin, Xie and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yichen Huang, Department of Urology, Shanghai Children's Hospital, Shanghai, China

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