ArticleOpen medicine (Warsaw, Poland)2026
Development of a clinical nomogram for predicting hemorrhagic rupture in renal angiomyolipoma and analysis of molecular correlates (
Article in Open medicine (Warsaw, Poland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Hemorrhagic rupture is a severe and potentially life-threatening complication of renal angiomyolipoma (AML). However, current clinical tools for accurately predicting hemorrhage risk remain limited. This study aimed to establish and validate a clinical nomogram for predicting hemorrhagic rupture in AML based on preoperative characteristics, and to investigate the underlying molecular correlates involving Methods: A total of 379 patients with AML and 40 normal kidney tissue samples (2010-2021) were retrospectively analyzed. Patients were temporally divided into a training cohort (n=285) and an independent temporal validation cohort (n=94). Independent clinical predictors of hemorrhagic rupture were identified through univariate and multivariate logistic regression and incorporated into a nomogram. Model performance was evaluated using receiver operating characteristic (ROC) analysis and calibration plots in the validation cohort. Additionally, immunohistochemistry, qPCR, and ELISA were conducted to assess Results: Tuberous sclerosis complex (TSC), tumor size ≥4 cm, rich vascular supply, and exophytic growth pattern were identified as independent predictors of hemorrhagic rupture (all p<0.05). The nomogram demonstrated excellent discrimination (AUC=0.967) and satisfactory calibration in the independent validation cohort. At the molecular level, immunohistochemical analysis revealed elevated Conclusions: The developed nomogram serves as a reliable pre-operative tool for individualized risk stratification of AML rupture. Furthermore, the aberrant expression of
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