目的：构建并验证可有效预测意外胆囊癌(incidental gallbladder cancer，IGBC)病人预后的列线图模型。方法：回顾性分析2011年5月至2022年10月西安交通大学第一附属医院收治的161例因IGBC而需根治手术病人的临床资料。使用COX比例风险回归模型筛选影响IGBC总体生存(OS)的影响因素。根据IGBC病人预后的独立影响因素构建列线图模型。利用一致性指数(concordance index, C-index)和校准曲线来验证模型的性能。利用受试者工作特征（receiver operating characteristic, ROC）曲线分析和决策曲线分析（decision curve analysis, DCA）来验证所绘制的列线图的预测精准度和净收益。结果：单因素COX回归分析提示，年龄、T分期、N分期、M分期、术前癌胚抗原(CEA)、术前糖类抗原(CA)19-9、术前红细胞体积分布宽度变异系数（RDW-CV）、治疗方式、复发转移是影响IGBC病人根治术后远期生存的危险因素。多因素COX回归分析提示，T分期、N分期、术前CA19-9、术前RDW-CV、术前天冬氨酸转氨酶(AST)、治疗方式、复发转移是影响IGBC病人预后的独立危险因素。所构建的列线图模型C-index为0.872。校准图显示列线图的良好性能。ROC曲线下面积为0.869，证实列线图的高精准度。DCA证实列线图模型的高净获益。结论：构建的列线图模型可准确、直观地预测IGBC病人根治术后生存概率。

Objective To construct and validate an effective prognostic nomogram for the patients with incidental gallbladder cancer(IGBC). Methods The clinical data of 161 patients with IGBC requiring radical surgery admitted to the First Affiliated Hospital of Xi’an Jiaotong University from May 2011 to October 2022 was analyzed retrospectively. COX proportional risk regression model was used to screen for influencing factors on overall survival(OS) of IGBC. Nomogram was constructed based on independent influencing factors that affected the prognosis of IGBC patients. The concordance index(C-index) and calibration curve were used to validate the performance of the model. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to validate the predictive accuracy and net benefit of the plotted column chart. Results Univariate COX regression analysis suggested that age, T stage, N stage, M stage, preoperative carcinoembryonic antigen(CEA), preoperative carbohydrate antigen19-9(CA19-9), preoperative red blood cell volume distribution on width coefficient of variation(RDW-CV), treatment method, and recurrence and metastasis were risk factors which affected the long-term survival of IGBC patients after radical surgery. Multivariate COX regression analysis suggested that T stage, N stage, preoperative CA19-9， preoperative RDW-CV, preoperative AST， treatment methods, and recurrence and metastasis were independent risk factors which affected the prognosis of IGBC patients. The C-index of the constructed prognostic model was 0.872. The calibration plot demonstrated good performance of the Nomogram. ROC curve analysis showed an area under the curve of 0.869, confirming a high sensitivity and specificity. A high net benefit was proven by DCA. Conclusions The constructed Nomogram can accurately and intuitively predict the survival probability of IGBC patients after radical surgery.