Liu Kunhui,Gong Yiming,Cai Wei.Efficacy verification of Nomogram tool for an early diagnosis of biliary atresia[J].Journal of Clinical Pediatric Surgery,,22():211-217.[doi:10.3760/cma.j.cn101785-202207050-003]
Efficacy verification of Nomogram tool for an early diagnosis of biliary atresia
- Keywords:
- Biliary Atresia; Nomograms; Gamma-Glutamyltransferase; Alkaline Phosphatase; Early Diagnosis
- Abstract:
- Objective To evaluate the efficacy of currently popular Nomogram prediction model for biliary atresia (BA) through a single-center data model.Methods Retrospective review was preformed for 631 children undergoing surgical explorations for infantile obstructive jaundice from 2009 to 2020.According to the findings of intraoperative cholangiography,they were assigned into two groups of BA (n=500) and non-BA (n=131).Gender,body weight,ALP (alkaline phosphatase),GGT (gamma glutamyltransferase) and DB (direct bilirubin) were input into the model for estimating the predicted risk probability of BA in the same child.They were grouped according to operative year and day age at surgery.The predicted probability of BA and other liver function parameters were plotted as receiver operating characteristic curve (ROC) curve in the same coordinate system.And area under the curve (AUC),sensitivity and specificity for diagnosing BA were obtained.Also the accuracy of model for an early diagnosis of BA was evaluated.Results Nomogram predictive model had higher AUC value and sensitivity for diagnosing BA than single parameter diagnosis.However,AUC value for diagnosing BA in children aged≤50 day or > 80 day was lower than that for GGT alone.Thus the prediction of pediatric BA using this model might not be accurate enough.Conclusion Nomogram predictive model has higher AUC value and sensitivity for diagnosing BA than single parameter diagnosis.However,AUC value for diagnosing BA in children aged≤50 day or ＞80 day is lower than that for GGT alone.
References:
[1] 沈桢,董瑞,汪吉梅,等.上海地区胆道闭锁筛查报告[J].中华小儿外科杂志,2020,41(11):989-993.DOI:10.3760/cma.j.cn421158-20190507-00336. Shen Z,Dong R,Wang JM,et al.Preliminary report for screening biliary atresia in Shanghai Area[J].Chin J Pediatr Surg,2020,41(11):989-993.DOI:10.3760/cma.j.cn421158-20190507-00336.
[2] Lien TH,Chang MH,Wu JF,et al.Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in Taiwan[J].Hepatology,2011,53(1):202-208.DOI:10.1002/hep.24023.
[3] 吕成超,肖静,向义,等.小儿胆道闭锁手术日龄的危险因素分析及策略[J].肝胆外科杂志,2020,28(3):190-193.DOI:10.3969/j.issn.1006-4761.2020.03.008. Lyu CC,Xiao J,Xiang Y,et al.Analysis and strategy of risk factors for operative day age of biliary atresia[J].J Hepatobiliary Surg,2020,28(3):190-193.DOI:10.3969/j.issn.1006-4761.2020.03.008.
[4] Dong R,Jiang JY,Zhang SH,et al.Development and validation of novel diagnostic models for biliary atresia in a large cohort of Chinese patients[J].E Bio Medicine,2018,34:223-230.DOI:10.1016/j.ebiom.2018.07.025.
[5] Chen XL,Dong R,Shen Z,et al.Value of gamma-glutamyl tran-speptidase for diagnosis of biliary atresia by correlation with age[J].J Pediatr Gastroenterol Nutr,2016,63(3):370-373.DOI:10.1097/MPG.0000000000001168.
[6] Rendón-Macías ME,Villasís-Keever MA,Casta?eda-Muci?o G,et al.Improvement in accuracy of gamma-glutamyl transferase for differential diagnosis of biliary atresia by correlation with age[J].Turk J Pediatr,2008,50(3):253-259.
[7] 姜璟,具钊汝,孙颖华,等.剪切波弹性成像诊断胆道闭锁价值的Meta分析[J].临床小儿外科杂志,2021,20(2):126-132.DOI:10.12260/lcxewkzz.2021.02.005. Jiang JY,Ju ZR,Sun YH,et al.Application of shear wave elastography for diagnosing biliary atresia:a Meta-analysis[J].J Clin Ped Sur,2021,20(2):126-132.DOI:10.12260/lcxewkzz.2021.02.005.
[8] Zhou KJ,Wang J,Xie GX,et al.Distinct plasma bile acid profiles of biliary atresia and neonatal hepatitis syndrome[J].J Proteome Res,2015,14(11):4844-4850.DOI:10.1021/acs.jproteome.5b00676.
[9] Zhou KJ,Xie GX,Wang J,et al.Metabonomics reveals metabolite changes in biliary atresia infants[J].J Proteome Res,2015,14(6):2569-2574.DOI:10.1021/acs.jproteome.5b00125.
[10] Dai SY,Sun YQ,Wu Y,et al.Development and assessment of screening nomogram for biliary atresia based on hepatobiliary ultrasonographic features[J].Front Pediatr,2021,9:625451.DOI:10.3389/fped.2021.625451.
[11] Huang CC,Chuang JH,Chou MH,et al.Matrilysin (MMP-7) is a major matrix metalloproteinase upregulated in biliary atresia-associated liver fibrosis[J].Mod Pathol,2005,18(7):941-950.DOI:10.1038/modpathol.3800374.
[12] Kerola A,Lampela H,Lohi J,et al.Increased MMP-7 expression in biliary epithelium and serum underpins native liver fibrosis after successful portoenterostomy in biliary atresia[J].J Pathol Clin Res,2016,2(3):187-198.DOI:10.1002/cjp2.50.
[13] 罗腾飞,胡文胜.超高效液相色谱-串联质谱法同时测定15种胆汁酸的方法分析[J].检验医学与临床,2018,15(16):2412-2415.DOI:10.3969/j.issn.1672-9455.2018.16.016. Luo TF,Hu WS.Analysis of simultaneous detection of 15 bile acids in human sera by ultra-performance liquid chromatography-tandem mass spectrometry[J].Lab Med Clin,2018,15(16):2412-2415.DOI:10.3969/j.issn.1672-9455.2018.16.016.
[14] Xiao YT,Liu RP,Li XJO,et al.Long noncoding RNA H19 contributes to cholangiocyte proliferation and cholestatic liver fibrosis in biliary atresia[J].Hepatology,2019,70(5):1658-1673.DOI:10.1002/hep.30698.
[15] Gu YH,Yokoyama K,Mizuta K,et al.Stool color card screening for early detection of biliary atresia and long-term native liver survival:a 19-year cohort study in Japan[J].J Pediatr,2015,166(4):897-902.e1.DOI:10.1016/j.jpeds.2014.12.063.
[16] Chen Y,Zhao DY,Gu SL,et al.Three-color risk stratification for improving the diagnostic accuracy for biliary atresia[J].Eur Radiol,2020,30(7):3852-3861.DOI:10.1007/s00330-020-06751-7
Memo
收稿日期:2022-7-26。
基金项目:上海市卫健委上海市临床重点专科建设项目-出生缺陷(shslczdzk05702)
通讯作者:蔡威,Email:caiw1978@163.com