Analysis of Risk Factors for Positive Margins in 198 Patients with High-grade Cervical Intraepithelial Neoplasia after Cervical ConizationConstruction and validation of a nomogram for the esophagogastric varices in patients with hepatitis B cirrhosis
Objective To explore the influencing factors of esophagogastric varices(EGV)in patients with hepatitis B cirrhosis,and to establish and validate the nomogram model.Methods Three hundred and three patients who were diagnosed with hepatitis B cirrhosis in the Third People's Hospital of Zhenjiang from Janu-ary 2018 to December 2022 were selected as the research objects.The training set and validation set were ran-domly constructed in a ratio of 7∶3.According to the results of endoscopic examination of esophageal and gastric varices,the patients were divided into varices group and non-varices group.The general information,laboratory and imaging indicators were collected.The variables were screened by LASSO regression,and the nomogram were constructed and verified by multivariate Logistic regression analysis of influencing factors.The clinical utility value of the model was assessed by receiver operator characteristic(ROC)curve,calibra-tion curve,decision curve(DCA),and clinical impact curve(CIC).Results The patients with hepatitis B cirrhosis in the study were divided into the training set(n=211)and validation set(n=92).The seven most likely non-zero coefficient characteristic variables were screened by LASSO regression:gender,LSM,PLT,TBIL,HGB,RBC,PT.Multivariate Logistic regression showed that gender(male)Multivariate Logistic regression showed that gender(male)(OR=4.830,95％CI:1.479～15.775,P=0.009),high LSM(OR=1.132,95％CI:1.009～1.270,P=0.034)and high TBIL(OR=1.133,95％CI:1.057～1.214,P＜0.001)were independent risk factors for the EGV in patients with hepatitis B cirrhosis,while High PLT(OR=0.978,95％CI:0.967～0.989,P＜0.001)was protective factor was protective factor.The nomo-gram was constructed with the above 4 influencing factors,ROC curves showed that the area under the curve(AUC)was 0.845(95％CI:0.793～0.896,P＜0.001)in the training set,and 0.932(95％CI:0.877～0.987,P＜0.001)in the validation set.The average absolute error of the training set was 0.040,and the validation set was 0.036,the calibration curve and the ideal curve were basically fitted.DCA curves of the training and validation sets showed that the nomogram had certain clinical practicability.CIC curves showed that the nomogram model can be used to forecast the high-risk population in different levels.Conclusion The nomogram constructed in this study has a high clinical utility and can provide evidence for clinicians to prelim-inary judge the risk of EGV in patients with hepatitis B cirrhosis.
Hepatitis BLiver cirrhosisEsophagogastric varicesNomogram
维普
万方数据
