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Using a random number method, the patients were divided into a training set (209 cases, 70%) and an internal validation set (89 cases, 30%). Additionally, 55 patients from two different medical centers, treated between January 2019 and January 2024 and meeting the same criter-ia, were included as an external validation set. Tumor size (OR\u2009=\u20092.70, 95% CI: 1.80\u20134.05,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), boundary (OR\u2009=\u20093.99, 95% CI: 1.34\u201311.86,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.013), AFP (OR\u2009=\u20097.49, 95% CI: 1.92\u201329.25,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.004), hCG (OR\u2009=\u20095.21, 95% CI: 1.30\u201320.95,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.020), and CDFI (Grade II: OR\u2009=\u20094.23, 95% CI: 1.35\u201313.26,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.014; Grade III: OR\u2009=\u200916.26, 95% CI: 3.68\u201371.83,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) were identified as five independent discriminative factors for distinguishing benign from malignant testicular tumors. A nomogram model incorporating these factors was constructed and demonstrated favorable performance. The model was deployed online as a dynamic nomogram (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/nomogram98.shinyapps.io\/dynnomapp\/\" ext-link-type=\"uri\">https:\/\/nomogram98.shinyapps.io\/dynnomapp\/<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-47759-1","type":"journal-article","created":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T16:25:57Z","timestamp":1776011157000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Construction and validation of a nomogram model for the differential diagnosis of primary testicular benign and malignant tumors"],"prefix":"10.1038","volume":"16","author":[{"given":"Chang-guo","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-chao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-xiang","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan-kui","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"47759_CR1","unstructured":"Tateo, V. et al. 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