Department of Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China.
Department of Interventional Radiology, Jinshan Hospital, Fudan University, 201508, Shanghai, China.
Am J Trop Med Hyg. 2023 Jan 23;108(3):569-577. doi: 10.4269/ajtmh.22-0267. Print 2023 Mar 1.
Clinical classification of advanced schistosomiasis japonica is important for treatment options and prognosis prediction. Network analysis was used to solve the problem of complexity and co-occurrence complications in classification of advanced schistosomiasis. A total of 4,125 retrospective patients were enrolled and divided randomly into a training cohort (n = 2,888) and a validation cohort (n = 1,237). Network analysis was used to cluster the isolated complications of advanced schistosomiasis. The accuracy of the network was evaluated. Nomograms based on the clustered complications were built to predict 1- to 5-year survival rates in advanced schistosomiasis. The predictive performance of the nomogram was also evaluated and validated. Fifteen isolated complications were identified: metabolic syndromes, minimal hepatic encephalopathy, hepatic encephalopathy, chronic obstructive pulmonary disease, pulmonary hypertension, respiratory failure, right heart failure, gastroesophageal variceal bleeding, gastrointestinal ulcer bleeding, splenomegaly, fibrosis, chronic kidney disease, ascites, colorectal polyp, and colorectal cancer. Through network analysis, three major clustered complications were achieved-namely, schistosomal abnormal metabolic syndromes (related to chronic metabolic abnormalities), schistosomal abnormal hemodynamics syndromes (related to severe portal hypertension and portosystemic shunting), and schistosomal inflammatory granulomatous syndromes (related to granulomatous inflammation). The nomograms showed a good performance in prognosis prediction of advanced schistosomiasis. The novel classification-based nomogram was useful in predicting the survival rate in advanced schistosomiasis japonica.
临床分期对日本血吸虫病的治疗选择和预后预测具有重要意义。网络分析用于解决晚期血吸虫病分类中的复杂性和并发并发症问题。共纳入 4125 例回顾性患者，随机分为训练队列（n = 2888）和验证队列（n = 1237）。网络分析用于聚类晚期血吸虫病的孤立并发症。评估网络的准确性。基于聚类并发症的列线图用于预测晚期血吸虫病 1 至 5 年的生存率。还评估和验证了列线图的预测性能。确定了 15 种孤立并发症：代谢综合征、轻微肝性脑病、肝性脑病、慢性阻塞性肺疾病、肺动脉高压、呼吸衰竭、右心衰竭、胃食管静脉曲张出血、胃肠道溃疡出血、脾肿大、纤维化、慢性肾脏病、腹水、结直肠息肉和结直肠癌。通过网络分析，实现了三个主要聚类并发症-即血吸虫异常代谢综合征（与慢性代谢异常有关）、血吸虫异常血液动力学综合征（与严重门静脉高压和门体分流有关）和血吸虫炎症性肉芽肿综合征（与肉芽肿性炎症有关）。列线图在晚期血吸虫病的预后预测中表现出良好的性能。基于新型分类的列线图可用于预测日本血吸虫病晚期的生存率。
