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Circulating biomarker-and magnetic resonance-based nomogram predicting long-term outcomes in dilated cardiomyopathy

Chinese Medical Journal 2024年第1期137卷 73-81页

作者： Yupeng Liu Wenyao Wang Jingjing Song Jiancheng Wang Yi Fu Yida Tang Department of Cardiology Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou 510080China Guangdong Cardiovascular Institute Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China Department of Cardiology Institute of Vascular MedicinePeking University Third HospitalBeijing 100191China Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems State Key Laboratory of Natural and Biomimetic DrugsSchool of Pharmaceutical SciencesPeking UniversityBeijing 100083China Department of Physiology and Pathophysiology School of Basic Medical SciencesPeking University Health Science CenterBeijing 100083China Key Laboratory of Molecular Cardiovascular Science Ministry of EducationBeijing 100191China

Background:Dilated cardiomyopathy(DCM)has a high mortality rate and is the most common indication for heart *** study sought to develop a multiparametric nomogram to assess individualized all-cause mortality or heart transplantation(ACM/HTx)risk in DCM ***:The present study is a retrospective cohort *** demographic,clinical,blood test,and cardiac magnetic resonance imaging(CMRI)data of DCM patients in the tertiary center(Fuwai Hospital)were *** primary endpoint was ACM/*** least absolute shrinkage and selection operator(LASSO)Cox regression model was applied for variable *** Cox regression was used to develop a *** concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and decision curve analysis(DCA)were used to evaluate the performance of the ***:A total of 218 patients were included in the present *** were randomly divided into a training cohort and a validation *** nomogram was established based on eight variables,including mid-wall late gadolinium enhancement,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume index,free triiodothyronine,and N-terminal pro-B type natriuretic *** AUCs regarding 1-year,3-year,and 5-year ACM/HTx events were 0.859,0.831,and 0.840 in the training cohort and 0.770,0.789,and 0.819 in the validation cohort,*** calibration curve and DCA showed good accuracy and clinical utility of the ***:We established and validated a circulating biomarker-and CMRI-based nomogram that could provide a personalized prediction of ACM/HTx for DCM patients,which might help risk stratification and decision-making in clinical practice.

关键词： Cardiomyopathy,dilated Heart transplantation Mortality Nomograms Least absolute shrinkage and selection operator decision curve analysis

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Diagnostic and economic value of carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 72-4 in gastrointestinal cancers

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World Journal of Gastroenterology 2023年第4期29卷 706-730页

作者： Hai-Ning Liu Can Yao Xiao-Fan Wang Ning-Ping Zhang Yan-Jie Chen Dong Pan Guo-Ping Zhao Xi-Zhong Shen Hao Wu Tao-Tao Liu Department of Gastroenterology and Hepatology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Gastroenterology and Hepatology Minhang District Central HospitalFudan UniversityShanghai 201199China Department of Internet Technology Center Zhongshan HospitalFudan UniversityShanghai 200032China Chinese National Human Genome Center at Shanghai Zhujiang HospitalCentral LabInstitute of Plant Physiology and EcologyShanghai Institute for Biological SciencesShanghai 200032China

BACKGROUND The diagnostic and economic value of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and CA72-4 for gastrointestinal malignant tumors lacked evaluation in a larger *** To reassess the diagnostic and economic value of the three tumor *** A retrospective analysis of all 32857 subjects who underwent CEA,CA19-9,CA72-4,gastroscopy and colonoscopy from October 2006 to May 2018 was ***,we assessed the discrimination and clinical *** cost,cost per capita and cost-effectiveness ratios were used to evaluate the economic value of two schemes(gastrointestinal endoscopy for all people without blood tests vs both gastroscopy and colonoscopy when blood tests were positive).RESULTS The analysis of 32857 subjects showed that CEA was a qualified biomarker for colorectal cancer(CRC),while the diagnostic efficiencies of CA72-4 were catastrophic for all gastrointestinal cancers(GICs).Regarding early diagnosis,only CEA could be used for early *** combination of biomarkers didn’t greatly increase the area under the *** economic indicators of CEA were superior to those of CA19-9,CA72-4 and any *** the threshold of 1.8μg/L to 10.4μg/L,all four indicators of CEA were lower than those in the scheme that conducted gastrointestinal endoscopy *** analysis implied that the health checkup of CEA for people above 65 years old was economically *** CEA had qualified diagnostic value for CRC and superior economic value for GICs,especially for elderly health checkup ***72-4 was not suitable as a diagnostic biomarker.

关键词： Diagnostic test Economic analysis Cost-effectiveness analysis decision curve analysis

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A Nomogram for Predicting the Likelihood of Obstructive Sleep Apnea to Reduce the Unnecessary Polysomnography Examinations

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Chinese Medical Journal 2015年第16期128卷 2134-2140页

作者： Miao Luo Hai-Yan Zheng Ying Zhang Yuan Feng Dan-Qing Li Xiao-Lin Li Jian-Fang Han Tao-Ping Li Department of Respiratory Medicine Hospital Affiliated Guilin Medical CollegeGuilinGuangxi 541001China Department of Biostatistics School of Public Health and Tropical MedicineSouthern Medical UniversityGuangzhouGuangdong 510515China Department of Clinical Epidemiology and Biostatistics Graduate School of MedicineOsaka UniversityJapan Department of Biostatistics School of Public Health and Tropical MedicineSouthern Medical UniversityGuangzhouGuangdong 510515China Department of Biostatistics and Bioinformatics School of MedicineDuke UniversityUSA Sleep Disorder Center Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China Sleep Disorder Center Nanfang Hospital Southern Medical University Guangzhou Guangdong 510515 China

Background：The currently available polysomnography （PSG） equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea （OSA） patients cannot receive timely diagnosis and treatment,we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG,based on the clinical syndromes and the demographic and anthropometric ***：The nomogram was constructed through an ordinal logistic regression *** accuracy and performance characteristics were assessed with the area under the curve （AUC） of the receiver operating characteristics and calibration plots,*** curve analyses were applied to assess the net benefit of the ***：Among the 401 patients,73 （18.2%） were diagnosed and grouped as the none OSA （apnea-hypopnea index [AHI] 〈5）,67 （16.7%） the mild OSA （5 ≤ AHI 〈 15）,82 （20.4%） the moderate OSA （15 ≤ AHI 〈 30）,and 179 （44.6%） the severe OSA （AHI ≥ 30）.The multivariable analysis suggested the significant factors were duration of disease,smoking status,difficulty of falling asleep,lack of energy,and waist circumference.A nomogram was created for the prediction of OSA using these clinical parameters and was internally validated using bootstrapping *** discrimination accuracies of the nomogram for any OSA,moderate-severe OSA,and severe OSA were 83.8%,79.9%,and 80.5%,respectively,which indicated good *** curve analysis showed that using nomogram could reduce the unnecessary polysomnography （PSG） by 10% without increasing the false ***：The established clinical nomogram provides high accuracy in predicting the individual risk of *** tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers.

关键词： decision curve analysis Nomogram Obstructive Polysomnography Risk Assessment Sleep Apnea

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Maximum Net Benefit Indicator and Its Applications

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Chinese Quarterly Journal of Mathematics 2022年第3期37卷 248-259页

作者： YANG Xiao-hui BAI Xin-yu LI Zi-xin HUANG Kun Henan Engineering Research Center for Artificial Intelligence Theory and Algorithms School of Mathematics and StatisticsHenan UniversityKaifeng 475004China Department of Medicine Indiana University School of MedicineIndianapolis 46202USA

Receiver operating characteristics(ROC)curve and the area under the curve(AUC)value are often used to illustrate the diagnostic ability of binary ***,both ROC and AUC focus on high accuracy in theory,which may not be effective for practical *** addition,it is difficult to judge which one is better when the ROC curves are intersect and the AUC values are *** curve analysis(DCA)methods improve ROC by incorporating accuracy and ***,similar to ROC,DCA requires a quantitative indicator to objectively determine which one is better when DCA curves intersect.A DCA-based statistical indicator named maximum net benefit(MNB)is constructed for evaluating clinical treatment regimens rather than just accuracy as in ROC and *** a simple and effective statistical indicator,the construction process of MNB is given ***,the MNB can still provide effective identification when the AUC values are equal,which is proved by ***,the feasibility and effectiveness of the proposed MNB are verified by gene selection and classifier performance comparison on actual data.

关键词： ROC AUC decision curve analysis Maximum net benefit(MNB)

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A nomogram for individualized estimation of survival among adult patients with adrenocortical carcinoma after surgery:a retrospective analysis and multicenter validation study

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Cancer Communications 2019年第1期39卷 683-695页

作者： Jianqiu Kong Junjiong Zheng Jinhua Cai Shaoxu Wu Xiayao Diao Weibin Xie Xiong Chen Chenyi Liao Hao Yu Xinxiang Fan Chaowen Huang Zhuowei Liu Wei Chen Qiang Lv Haide Qin Jian Huang Tianxin Lin Department of Urology Sun Yat-Sen Memorial HospitalSun Yat-Sen University107 Yan Jiang West RoadGuangzhou 510120GuangdongP.R.China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120GuangdongP.R.China Department of Neurology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120GuangdongP.R.China Department of Obstetrics and Gynecology Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630GuangdongP.R.China Department of Urology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Urology First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080GuangdongP.R.China Department of Urology The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029JiangsuP.R.China State Key Laboratory of Oncology in South China Guangzhou 510120GuangdongP.R.China

Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is *** objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after ***:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December *** endpoint of this study was *** nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical *** nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),***:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),***,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup *** curve analysis indicated that the nomogram wa

关键词： Adrenocortical carcinoma Adult patients Overall survival Nomogram Validation decision curve analysis Surveillance Epidemiology and End Results(SEER) The Cancer Genome Atlas(TCGA) Multicenter

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Development and validation of a prognostic nomogram model for Chinese patients with primary small cell carcinoma of the esophagus

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World Journal of Clinical Cases 2021年第30期9卷 9011-9022页

作者： Dong-Yun Zhang Gai-Rong Huang Jian-Wei Ku Xue-Ke Zhao Xin Song Rui-Hua Xu Wen-Li Han Fu-You Zhou Ran Wang Meng-Xia Wei Li-Dong Wang Department of Pathology Nanyang Medical CollegeNanyang 473061Henan ProvinceChina State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Geriatrics Henan People’s HospitalZhengzhou 450003Henan ProvinceChina Department of Endoscopy of The Third Affiliated Hospital Nanyang Medical CollegeNanyang 473061Henan ProvinceChina Department of Thoracic Surgery Anyang Tumor HospitalAnyang 455000Henan ProvinceChina

BACKGROUND Primary small cell carcinoma of the esophagus(PSCE)is a highly invasive malignant tumor with a poor prognosis compared with esophageal squamous cell *** to the limited samples size and the short follow-up time,there are few reports on elucidating the prognosis of PSCE,especially on the establishment and validation of a survival prediction nomogram model covering general information,pathological factors and specific biological proteins of PSCE *** To establish an effective nomogram to predict the overall survival(OS)probability for PSCE patients in *** The nomogram was based on a retrospective study of 256 PSCE *** analysis and multivariate Cox proportional hazards regression analysis were used to examine the prognostic factors associated with PSCE,and establish the model for predicting 1-,3-,and 5-year OS based on the Akaike information *** and validation were assessed by the concordance index(C-index)and calibration curve and decision curve analysis(DCA).Histology type,age,tumor invasion depth,lymph node invasion,detectable metastasis,chromogranin A,and neuronal cell adhesion molecule 56 were integrated into the *** The C-index was prognostically superior to the 7th tumor node metastasis(TNM)staging in the primary cohort[0.659(95%CI:0.607-0.712)vs 0.591(95%CI:0.517-0.666),P=0.033]and in the validation cohort[0.700(95%CI:0.622-0.778)vs 0.605(95%CI:0.490-0.721),P=0.041].Good calibration curves were observed for the prediction probabilities of 1-,3-,and 5-year OS in both *** analysis showed that our nomogram model had a higher overall net benefit compared to the 7th TNM *** Our nomogram can be used to predict the survival probability of PSCE patients,which can help clinicians to make individualized survival predictions.

关键词： Primary small cell carcinoma decision curve analysis Esophagus Nomogram Prognosis

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Liver fibrosis index-based nomograms for identifying esophageal varices in patients with chronic hepatitis B related cirrhosis

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World Journal of Gastroenterology 2020年第45期26卷 7204-7221页

作者： Shi-Hao Xu Fang Wu Le-Hang Guo Wei-Bing Zhang Hui-Xiong Xu Department of Medical Ultrasound Shanghai Tenth People’s Hospital of Nanjing Medical UniversityShanghai 200072China Department of Ultrasonography The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Esophageal varices(EV)are the most fatal complication of chronic hepatitis B(CHB)related *** prognosis is poor,especially after the first upper gastrointestinal *** To construct nomograms to predict the risk and severity of EV in patients with CHB related *** Between 2016 and 2018,the patients with CHB related cirrhosis were recruited and divided into a training or validation cohort at The First Affiliated Hospital of Wenzhou Medical *** and ultrasonic parameters that were closely related to EV risk and severity were screened out by univariate and multivariate logistic regression analyses,and integrated into two nomograms,*** nomograms were internally and externally validated by calibration,concordance index(C-index),receiver operating characteristic curve,and decision curve analyses(DCA).RESULTS A total of 307 patients with CHB related cirrhosis were *** independent risk factors for EV included Child-Pugh class[odds ratio(OR)=7.705,95%confidence interval(CI)=2.169-27.370,P=0.002],platelet count(OR=0.992,95%CI=0.984-1.000,P=0.044),splenic portal index(SPI)(OR=3.895,95%CI=1.630-9.308,P=0.002),and liver fibrosis index(LFI)(OR=3.603,95%CI=1.336-9.719,P=0.011);those of EV severity included Child-Pugh class(OR=5.436,95%CI=2.112-13.990,P<0.001),mean portal vein velocity(OR=1.479,95%CI=1.043-2.098,P=0.028),portal vein diameter(OR=1.397,95%CI=1.021-1.912,P=0.037),SPI(OR=1.463,95%CI=1.030-2.079,P=0.034),and LFI(OR=3.089,95%CI=1.442-6.617,P=0.004).Two nomograms(predicting EV risk and severity,respectively)were well-calibrated and had a favorable discriminative ability,with C-indexes of 0.916 and 0.846 in the training cohort,respectively,higher than those of other predictive indexes,like LFI(C-indexes=0.781 and 0.738),SPI(C-indexes=0.805 and 0.714),ratio of platelet count to spleen diameter(PSR)(C-indexes=0.822 and 0.726),King’s score(C-indexes=0.694 and 0.609),and Lok index(C-indexes=0.788 a

关键词： Real-time tissue elastography Chronic hepatitis B Cirrhosis Esophageal varices Nomogram decision curve analysis

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Gut Microbiota in Children with Juvenile Idiopathic Arthritis: The Characteristics, Biomarker Identification, and Its Usefulness in Clinical Prediction

Gut Microbiota in Children with Juvenile Idiopathic Arthriti...

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2019年浙江省全科医学学术大会

作者：钱旭波 Yong-Xin Liu Xiaohong Ye Wenjie Zheng Shaoxia Lv Miaojun Mo Jinjing Lin Wenqin Wang Weihan Wang Xianning Zhang Meiping Lu Department of Rheumatology Immunology & Allergy Children's Hospital Zhejiang University School of Medicine Department of Pediatrics Xiguan Community Healthcare Center Department of Scientific Research Management and Medical Education Jinhua Hospital of Traditional Chinese Medicine State Key Laboratory of Plant Genomics Institute of Genetics and Developmental Biology Chinese Academy of Sciences Department of Paediatric Rheumatology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Nursing Department Jiangnan Community Healthcare Center Department of Pediatrics Wenling Maternal and Child Healthcare Hospital Department of Pediatrics Shaoxing People's Hospital Shaoxing Hospital Zhejiang University School of Medicine Department of Rheumatology Immunology Jinhua Municipal People's Hospital Department of Genetics Institute of Genetics Institute of Cell Biology Zhejiang University School of Medicine

Objective Recent studies have suggested that the gut microbiota is altered in children with juvenile idiopathic arthritis(JIA). However, age, sex, body mass index(BMI) were not matched in the previous studies, and the results are inconsistent. We conducted an age-, sex-, and BMI-matched cross-sectional study to characterize the gut microbiota in children with JIA, and evaluate its potential in clinical *** A total of 40 patients with JIA and 42 healthy controls, ranging from 1 to 16 years, were enrolled in this study at two tertiary hospitals in Zhejiang province, China. Fecal samples were collected for 16 S rDNA sequencing. The data was analyzed using QIIME software and R packages. Specifically, the random forest, a commonly used machine learning method, was used to identify biomarkers, and the receiver operating characteristic curve and the decision curve analysis were used to evaluate model *** The Shannon-Wiener index in the JIA group was smaller than that in the control group(p = 0.031). The Bray-Curtis dissimilarity differed significantly between the two groups(p = 0.019, R2 = 0.021). The relative abundance of four genera, Anaerostipes, Dialister, Lachnospira, and Roseburia, decreased significantly in the JIA group compared with those in the control group(adjusted p = 0.031, 0.013, 0.041, and 0.011, respectively). The four genera were microbes that produce short-chain fatty acids(SCFAs) and were correlated with some rheumatic indices. Moreover, twelve genera were identified as potential biomarkers by using the nested cross-validation function of the random forest. A random forest model constructed using these biomarkers was able to differentiate the patients with JIA from the healthy controls, and the area under the receiver operating characteristic curve was 0.7975. The decision curve analysis indicated that the model had usefulness in clinical *** The gut microbiota is altered in patients with JIA, characterize

关键词： juvenile idiopathic arthritis microbiota short-chain fatty acids butyrate propionate biomarker machine learning decision curve analysis

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