Table 1 The baseline characteristics of the training, internal validation, external testing, and real-world cohorts
Variables | Overall (n = 1246) | The training cohort (n = 674) | The internal validation cohort (n = 169) | The external testing cohort (n = 279) | Real-world cohort (n = 124) |
|---|---|---|---|---|---|
Category | |||||
XGC | 554 (44.5) | 326 (48.4) | 82 (48.5) | 90 (32.3) | 56 (45.2) |
GBC | 692 (55.5) | 348 (51.6) | 87 (51.5) | 189 (67.7) | 68 (54.8) |
Clinical variables | |||||
Sex | |||||
Female | 672 (53.9) | 361 (53.6) | 84 (49.7) | 162 (58.1) | 65 (52.4) |
Male | 574 (46.1) | 313 (46.4) | 85 (50.3) | 117 (41.9) | 59 (47.6) |
Age (years)a | 63.00 [55.00, 71.00] | 62.00 [54.00, 70.00] | 64.00 [57.00, 71.00] | 65.00 [57.00, 73.00] | 65.00 [58.00, 72.00] |
Symptoms | |||||
Asymptomatic | 312 (25.0) | 159 (23.6) | 50 (29.6) | 57 (20.4) | 46 (37.1) |
Fever | 36 (2.9) | 13 (1.9) | 4 (2.4) | 11 (3.9) | 8 (6.5) |
Epigastric pain | 720 (57.8) | 401 (59.5) | 84 (49.7) | 187 (67.0) | 48 (38.7) |
Jaundice | 71 (5.7) | 46 (6.8) | 8 (4.7) | 10 (3.6) | 7 (5.6) |
Gastrointestinal symptoms | 63 (5.1) | 31 (4.6) | 12 (7.1) | 11 (3.9) | 9 (7.3) |
Weight loss | 4 (0.3) | 3 (0.4) | 0 (0.0) | 0 (0.0) | 1 (0.8) |
Others | 40 (3.2) | 21 (3.1) | 11 (6.5) | 3 (1.1) | 5 (4.0) |
Complications | |||||
None | 1105 (88.7) | 599 (88.9) | 143 (84.6) | 255 (91.4) | 108 (87.1) |
Abscess | 31 (2.5) | 15 (2.2) | 8 (4.7) | 5 (1.8) | 3 (2.4) |
Severe pancreatitis | 38 (3.0) | 21 (3.1) | 7 (4.1) | 8 (2.9) | 2 (1.6) |
Perforation | 28 (2.2) | 10 (1.5) | 5 (3.0) | 9 (3.2) | 4 (3.2) |
Colon obstruction | 25 (2.0) | 17 (2.5) | 3 (1.8) | 1 (0.4) | 4 (3.2) |
Two or more above | 19 (1.5) | 12 (1.8) | 3 (1.8) | 1 (0.4) | 3 (2.4) |
Smoking | |||||
Absent | 1079 (86.6) | 559 (82.9) | 151 (89.3) | 253 (90.7) | 116 (93.5) |
Present | 167 (13.4) | 115 (17.1) | 18 (10.7) | 26 (9.3) | 8 (6.5) |
Diabetes | |||||
Absent | 1087 (87.2) | 579 (85.9) | 146 (86.4) | 249 (89.2) | 113 (91.1) |
Present | 159 (12.8) | 95 (14.1) | 23 (13.6) | 30 (10.8) | 11 (8.9) |
Gallbladder adenomyomatosis | |||||
Absent | 1191 (95.6) | 649 (96.3) | 156 (92.3) | 268 (96.1) | 118 (95.2) |
Present | 55 (4.4) | 25 (3.7) | 13 (7.7) | 11 (3.9) | 6 (4.8) |
Biliary tract infection | |||||
Absent | 1144 (91.8) | 648 (96.1) | 160 (94.7) | 224 (80.3) | 112 (90.3) |
Present | 102 (8.2) | 26 (3.9) | 9 (5.3) | 55 (19.7) | 12 (9.7) |
Other conditions (schistosomiasis, congenital biliary dilatation/cyst) | |||||
Absent | 1197 (96.1) | 647 (96.0) | 161 (95.3) | 269 (96.4) | 120 (96.8) |
Present | 49 (3.9) | 27 (4.0) | 8 (4.7) | 10 (3.6) | 4 (3.2) |
Imaging variables | |||||
Ultrasound echo | |||||
Hypoechoic | 499 (40.0) | 265 (39.3) | 68 (40.2) | 109 (39.1) | 57 (46.0) |
Mixed echogenicity | 42 (3.4) | 9 (1.3) | 1 (0.6) | 32 (11.5) | 0 (0.0) |
Isoechoic | 476 (38.2) | 271 (40.2) | 67 (39.6) | 96 (34.4) | 42 (33.9) |
Hyperechoic | 229 (18.4) | 129 (19.1) | 33 (19.5) | 42 (15.1) | 25 (20.2) |
Blood flow signal | |||||
None | 609 (48.9) | 348 (51.6) | 89 (52.7) | 110 (39.4) | 62 (50.0) |
Sparse | 542 (43.5) | 284 (42.1) | 74 (43.8) | 133 (47.7) | 51 (41.1) |
Abundant | 95 (7.6) | 42 (6.2) | 6 (3.6) | 36 (12.9) | 11 (8.9) |
Gallbladder stones | |||||
Absent | 368 (29.5) | 197 (29.2) | 49 (29.0) | 77 (27.6) | 45 (36.3) |
Present | 878 (70.5) | 477 (70.8) | 120 (71.0) | 202 (72.4) | 79 (63.7) |
Biliary duct dilation | |||||
Absent | 827 (66.4) | 438 (65.0) | 121 (71.6) | 181 (64.9) | 87 (70.2) |
Present | 419 (33.6) | 236 (35.0) | 48 (28.4) | 98 (35.1) | 37 (29.8) |
Gallbladder morphology | |||||
Irregular | 314 (25.2) | 150 (22.3) | 56 (33.1) | 74 (26.5) | 34 (27.4) |
Regular | 932 (74.8) | 524 (77.7) | 113 (66.9) | 205 (73.5) | 90 (72.6) |
Gallbladder size | |||||
Normal | 583 (46.8) | 327 (48.5) | 74 (43.8) | 123 (44.1) | 59 (47.6) |
Enlarged | 494 (39.6) | 250 (37.1) | 66 (39.1) | 128 (45.9) | 50 (40.3) |
Reduced | 169 (13.6) | 97 (14.4) | 29 (17.2) | 28 (10.0) | 15 (12.1) |
Type of gallbladder wall thickening | |||||
Diffuse | 605 (48.6) | 356 (52.8) | 90 (53.3) | 108 (38.7) | 51 (41.1) |
Focal | 537 (43.1) | 299 (44.4) | 67 (39.6) | 104 (37.3) | 67 (54.0) |
None | 104 (8.3) | 19 (2.8) | 12 (7.1) | 67 (24.0) | 6 (4.8) |
Intramural nodules | |||||
Absent | 991 (79.5) | 518 (76.9) | 141 (83.4) | 244 (87.5) | 88 (71.0) |
Present | 255 (20.5) | 156 (23.1) | 28 (16.6) | 35 (12.5) | 36 (29.0) |
Intraluminal tumor | |||||
Absent | 762 (61.2) | 406 (60.2) | 103 (60.9) | 185 (66.3) | 68 (54.8) |
Present | 484 (38.8) | 268 (39.8) | 66 (39.1) | 94 (33.7) | 56 (45.2) |
Mucosal line | |||||
Discontinuous | 801 (64.3) | 428 (63.5) | 100 (59.2) | 185 (66.3) | 88 (71.0) |
Continuous | 445 (35.7) | 246 (36.5) | 69 (40.8) | 94 (33.7) | 36 (29.0) |
Gallbladder perforation | |||||
Absent | 1200 (96.3) | 654 (97.0) | 162 (95.9) | 266 (95.3) | 118 (95.2) |
Present | 46 (3.7) | 20 (3.0) | 7 (4.1) | 13 (4.7) | 6 (4.8) |
Abscess | |||||
Absent | 1208 (97.0) | 654 (97.0) | 158 (93.5) | 276 (98.9) | 120 (96.8) |
Present | 38 (3.0) | 20 (3.0) | 11 (6.5) | 3 (1.1) | 4 (3.2) |
Invasion of adjacent structures | |||||
Intrahepatic | 316 (25.4) | 194 (28.8) | 43 (25.4) | 48 (17.2) | 31 (25.0) |
Extrahepatic | 33 (2.6) | 23 (3.4) | 3 (1.8) | 3 (1.1) | 4 (3.2) |
Intra- and extrahepatic | 77 (6.2) | 45 (6.7) | 10 (5.9) | 12 (4.3) | 10 (8.1) |
None | 820 (65.8) | 412 (61.1) | 113 (66.9) | 216 (77.4) | 79 (63.7) |
Enlarged peri-tumoral lymph nodes | |||||
Absent | 958 (76.9) | 517 (76.7) | 130 (76.9) | 216 (77.4) | 95 (76.6) |
Present | 288 (23.1) | 157 (23.3) | 39 (23.1) | 63 (22.6) | 29 (23.4) |
Density (plain CT) | |||||
Isodense | 366 (29.4) | 198 (29.4) | 44 (26.0) | 92 (33.0) | 32 (25.8) |
Hyperdense | 723 (58.0) | 383 (56.8) | 111 (65.7) | 154 (55.2) | 75 (60.5) |
Hypodense | 157 (12.6) | 93 (13.8) | 14 (8.3) | 33 (11.8) | 17 (13.7) |
Tumor enhancement pattern (CE-CT) | |||||
Markedly enhanced | 759 (60.9) | 426 (63.2) | 113 (66.9) | 142 (50.9) | 78 (62.9) |
Mildly enhanced | 452 (36.3) | 242 (35.9) | 55 (32.5) | 109 (39.1) | 46 (37.1) |
No enhancement | 35 (2.8) | 6 (0.9) | 1 (0.6) | 28 (10.0) | 0 (0.0) |
T2WI signal | |||||
Isointense | 189 (15.2) | 110 (16.3) | 12 (7.1) | 57 (20.4) | 10 (8.1) |
Hyperintense | 1013 (81.3) | 543 (80.6) | 147 (87.0) | 213 (76.3) | 110 (88.7) |
Hypointense | 44 (3.5) | 21 (3.1) | 10 (5.9) | 9 (3.2) | 4 (3.2) |
DWI signal | |||||
Isointense | 1008 (80.9) | 562 (83.4) | 147 (87.0) | 196 (70.3) | 103 (83.1) |
Hyperintense | 238 (19.1) | 112 (16.6) | 22 (13.0) | 83 (29.7) | 21 (16.9) |
Hypointense | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Tumor enhancement pattern (CE-MRI) | |||||
Markedly enhanced | 985 (79.1) | 560 (83.1) | 145 (85.8) | 174 (62.4) | 106 (85.5) |
Mildly enhanced | 241 (19.3) | 109 (16.2) | 24 (14.2) | 90 (32.3) | 18 (14.5) |
No enhancement | 20 (1.6) | 5 (0.7) | 0 (0.0) | 15 (5.4) | 0 (0.0) |
Laboratory variables | |||||
White Blood Cell (×109/L)a | 6.30 [5.00, 8.10] | 6.10 [5.00, 7.88] | 6.40 [5.21, 8.42] | 6.30 [4.80, 8.12] | 6.83 [5.64, 9.77] |
Neutrophil (×109/L)a | 4.00 [3.00, 5.66] | 3.90 [3.00, 5.40] | 4.15 [3.16, 6.11] | 4.10 [2.89, 5.88] | 4.50 [3.46, 7.14] |
Lymphocyte (×109/L)a | 1.46 [1.10, 1.90] | 1.53 [1.14, 1.91] | 1.51 [1.14, 1.92] | 1.30 [0.96, 1.73] | 1.44 [1.09, 1.90] |
Monocyte (×109/L)a | 0.41 [0.31, 0.56] | 0.40 [0.31, 0.54] | 0.43 [0.33, 0.57] | 0.40 [0.30, 0.60] | 0.43 [0.35, 0.61] |
Eosinophil (×109/L)a | 0.09 [0.05, 0.17] | 0.10 [0.06, 0.19] | 0.09 [0.04, 0.17] | 0.08 [0.03, 0.14] | 0.08 [0.03, 0.15] |
Basophil (×109/L)a | 0.02 [0.01, 0.04] | 0.02 [0.02, 0.04] | 0.03 [0.02, 0.04] | 0.02 [0.01, 0.03] | 0.02 [0.01, 0.03] |
Red Blood Cell (×1012/L)a | 4.29 [3.94, 4.70] | 4.33 [4.00, 4.73] | 4.27 [3.92, 4.77] | 4.21 [3.90, 4.56] | 4.31 [3.92, 4.66] |
Hemoglobin (g/L)a | 130.00 [118.00, 140.00] | 130.00 [120.00, 141.00] | 130.00 [119.00, 142.00] | 127.00 [117.00, 138.00] | 130.00 [115.00, 138.25] |
PLT (×109/L)a | 218.00 [177.00, 275.75] | 221.00 [180.00, 284.50] | 222.00 [189.00, 281.00] | 200.00 [157.00, 242.50] | 225.50 [182.50, 292.00] |
INRa | 0.99 [0.94, 1.05] | 0.98 [0.94, 1.04] | 1.01 [0.96, 1.07] | 1.00 [0.95, 1.07] | 0.99 [0.96, 1.04] |
Fibrinogen (g/L)a | 3.51 [2.85, 4.61] | 3.49 [2.77, 4.63] | 3.52 [2.97, 4.64] | 3.49 [2.92, 4.50] | 3.55 [2.95, 4.75] |
Activated Partial Thromboplastin Time (S)a | 27.90 [25.70, 30.50] | 27.20 [25.10, 29.60] | 28.10 [26.40, 29.80] | 29.60 [25.90, 33.95] | 28.55 [27.10, 30.50] |
Thrombin Time (S)a | 17.50 [16.50, 18.40] | 17.70 [16.90, 18.50] | 17.00 [16.40, 17.70] | 17.90 [16.05, 19.65] | 16.65 [16.10, 17.40] |
Prothrombin Time (S)a | 11.60 [11.00, 12.40] | 11.50 [10.90, 12.10] | 11.70 [11.10, 12.50] | 11.90 [11.10, 12.80] | 11.60 [11.20, 12.10] |
D-Dimera | 580.00 [281.00, 1279.00] | 566.00 [269.25, 1190.00] | 677.00 [303.00, 1403.00] | 580.00 [290.00, 1385.00] | 606.00 [313.50, 1400.50] |
Total Protein (g/L)a | 70.45 [64.60, 74.80] | 70.05 [64.82, 74.57] | 71.80 [67.50, 74.80] | 69.00 [62.30, 74.50] | 72.60 [65.90, 76.53] |
Albumin (g/L)a | 41.70 [37.70, 45.00] | 42.20 [38.10, 45.48] | 43.20 [39.50, 45.80] | 39.30 [35.30, 42.60] | 42.60 [37.85, 46.92] |
Globulin (g/L)a | 28.00 [24.80, 31.37] | 27.40 [24.30, 30.70] | 28.00 [24.90, 31.30] | 29.20 [26.40, 32.95] | 28.65 [25.45, 31.52] |
ALT (U/L)a | 23.00 [14.00, 54.00] | 21.00 [14.00, 46.00] | 25.00 [14.00, 78.00] | 24.30 [14.00, 68.85] | 24.50 [14.75, 55.00] |
AST (U/L)a | 22.00 [17.00, 38.00] | 21.00 [17.00, 33.00] | 23.00 [18.00, 43.00] | 22.60 [18.30, 53.55] | 24.00 [17.75, 39.00] |
ALP (U/L)a | 99.00 [75.25, 145.00] | 97.00 [74.00, 145.00] | 102.00 [80.00, 144.00] | 101.00 [76.00, 157.10] | 95.00 [79.75, 126.25] |
Cholinesterase (U/L)a | 7399.50 [6018.00, 8830.50] | 7327.50 [5987.00, 8617.00] | 7547.00 [6385.00, 8837.00] | 7425.00 [6286.50, 9240.50] | 7442.00 [5748.75, 8895.00] |
Total Bile Acid (µmol/L)a | 6.00 [4.00, 10.39] | 6.00 [4.00, 10.50] | 5.60 [4.00, 8.90] | 6.08 [3.40, 12.71] | 5.60 [3.90, 8.67] |
Total Bilirubin (µmol/L)a | 12.60 [9.00, 20.90] | 12.00 [8.60, 20.00] | 12.10 [8.70, 18.30] | 15.30 [10.90, 25.35] | 12.65 [8.88, 17.92] |
Direct Bilirubin (µmol/L)a | 4.90 [3.50, 8.88] | 4.50 [3.30, 8.30] | 5.00 [3.50, 8.30] | 5.50 [3.80, 10.00] | 5.45 [3.68, 8.22] |
Indirect Bilirubin (µmol/L)a | 7.40 [5.00, 10.97] | 7.00 [4.90, 10.38] | 6.20 [4.60, 9.10] | 9.20 [6.70, 14.05] | 7.05 [4.70, 9.83] |
Gamma-Glutamyl Transferase (U/L)a | 44.00 [21.70, 148.75] | 46.00 [22.00, 149.00] | 43.00 [21.00, 130.00] | 48.00 [21.25, 206.15] | 37.50 [21.00, 104.25] |
Glomerular Filtration Ratea | 91.14 [80.26, 99.92] | 92.01 [82.06, 100.74] | 90.60 [80.70, 98.20] | 89.59 [74.26, 99.00] | 89.75 [80.14, 97.80] |
Creatinine (µmol/L)a | 67.00 [57.00, 79.00] | 67.00 [57.00, 78.00] | 67.00 [56.00, 80.00] | 67.70 [58.90, 81.00] | 67.50 [56.00, 81.25] |
Urea (mmol/L)a | 4.60 [3.70, 5.84] | 4.67 [3.79, 5.74] | 4.56 [3.82, 6.00] | 4.45 [3.48, 5.97] | 4.72 [3.75, 6.02] |
Uric Acid (µmol/L)a | 279.00 [220.00, 344.60] | 281.00 [223.00, 349.00] | 278.00 [209.00, 337.00] | 274.50 [214.60, 339.00] | 282.00 [212.00, 346.00] |
Triglycerides (mmol/L)a | 1.26 [0.92, 1.79] | 1.31 [0.95, 1.91] | 1.22 [0.98, 1.69] | 1.21 [0.88, 1.69] | 1.22 [0.86, 1.75] |
Total Cholesterol (mmol/L)a | 4.26 [3.61, 4.96] | 4.17 [3.53, 4.87] | 4.24 [3.66, 5.04] | 4.47 [3.80, 5.20] | 4.21 [3.57, 4.82] |
High-Density Lipoprotein (mmol/L)a | 1.11 [0.85, 1.43] | 1.03 [0.80, 1.27] | 1.10 [0.85, 1.38] | 1.59 [1.00, 2.93] | 1.06 [0.86, 1.38] |
Low-Density Lipoprotein (mmol/L)a | 2.41 [1.86, 3.18] | 2.31 [1.81, 2.86] | 2.28 [1.78, 2.89] | 3.62 [2.37, 6.48] | 2.24 [1.71, 2.76] |
Fasting Blood Glucose (mmol/L)a | 5.31 [4.75, 6.21] | 5.17 [4.64, 5.98] | 5.48 [4.97, 6.37] | 5.38 [4.78, 6.85] | 5.54 [5.05, 6.39] |
AFP (ng/mL)a | 2.60 [1.90, 3.56] | 2.70 [1.90, 3.60] | 2.70 [2.10, 3.60] | 2.45 [1.85, 3.34] | 2.75 [1.87, 3.73] |
CEA (ng/mL)a | 2.50 [1.60, 3.93] | 2.40 [1.60, 3.80] | 2.50 [1.70, 4.50] | 2.70 [1.73, 3.94] | 2.35 [1.78, 3.60] |
CA125 (ng/mL)a | 16.90 [10.80, 30.30] | 17.05 [10.93, 30.48] | 18.10 [11.60, 38.10] | 16.00 [10.10, 25.95] | 16.95 [11.57, 30.55] |
CA199 (ng/mL)a | 22.04 [6.50, 160.17] | 22.30 [6.30, 152.40] | 14.90 [6.80, 114.80] | 24.76 [5.92, 209.66] | 31.85 [7.25, 188.00] |
Ferroprotein (ng/mL)a | 263.30 [134.25, 478.50] | 252.70 [121.45, 461.75] | 302.00 [150.70, 522.70] | 257.70 [140.50, 472.15] | 297.55 [143.17, 570.60] |
NLRa | 2.71 [1.82, 4.42] | 2.55 [1.74, 3.89] | 2.78 [1.90, 4.00] | 3.00 [1.92, 5.83] | 3.17 [2.04, 6.33] |
dNLRa | 1.90 [1.38, 2.89] | 1.82 [1.35, 2.65] | 2.02 [1.43, 2.81] | 2.00 [1.41, 3.53] | 2.07 [1.46, 3.57] |
PLRa | 149.73 [113.34, 205.62] | 149.11 [112.37, 200.65] | 150.94 [119.88, 211.43] | 148.67 [108.82, 205.53] | 154.01 [117.47, 234.58] |
LMRa | 3.65 [2.38, 5.03] | 3.93 [2.59, 5.39] | 3.64 [2.58, 4.88] | 3.02 [2.00, 4.63] | 3.51 [1.95, 4.80] |
AFRa | 11.72 [8.60, 15.41] | 12.04 [8.70, 15.99] | 11.66 [8.83, 15.13] | 11.05 [8.24, 13.89] | 12.42 [8.62, 15.29] |
PFRa | 61.71 [46.64, 79.31] | 63.96 [50.00, 81.91] | 61.68 [47.56, 78.81] | 54.41 [42.15, 70.81] | 64.90 [44.82, 83.56] |
CA199-to-TB Ratioa | 1.63 [0.47, 8.77] | 1.68 [0.47, 7.97] | 1.38 [0.52, 10.04] | 1.60 [0.45, 8.78] | 1.91 [0.49, 12.87] |
SIIa | 582.47 [374.47, 1102.63] | 564.83 [361.93, 960.26] | 669.20 [402.65, 1100.90] | 532.63 [355.37, 1188.44] | 721.63 [417.22, 1494.23] |
PNIa | 49.50 [44.30, 53.90] | 50.17 [44.91, 54.30] | 51.10 [46.60, 54.50] | 46.40 [41.12, 50.70] | 50.60 [44.45, 55.11] |
CNSa | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] | 1.00 [0.00, 2.00] |
