Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 West Yanjiang Road, Guangzhou, 510120, China.
Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
BMC Ophthalmol. 2023 Jan 23;23(1):28. doi: 10.1186/s12886-022-02745-9.
To develop and validate a nomogram model for predicting chronic ocular graft-versus-host disease (coGVHD) in patients after allogenic haematopoietic stem cell transplantation (allo-HSCT).
This study included 61 patients who survived at least 100 days after allo-HSCT. Risk factors for coGVHD were screened using LASSO regression, then the variables selected were subjected to logistic regression. Nomogram was established to further confirm the risk factors for coGVHD. Receiver operating characteristic (ROC) curves were constructed to assess the performance of the predictive model with the training and test sets. Odds ratios and 95% confidence intervals (95% CIs) were calculated by using logistic regression analysis.
Among the 61 patients, 38 were diagnosed with coGVHD. We selected five texture features: lymphocytes (LYM) (OR = 2.26), plasma thromboplastin antecedent (PTA) (OR = 1.19), CD3 + CD25 + cells (OR = 1.38), CD3 + HLA-DR + cells (OR = 0.95), and the ocular surface disease index (OSDI) (OR = 1.44). The areas under the ROC curve (AUCs) of the nomogram with the training and test sets were 0.979 (95% CI, 0.895-1.000) and 0.969 (95% CI, 0.846-1.000), respectively.And the Hosmer-Lemeshow test was nonsignificant with the training (p = 0.9949) and test sets (p = 0.9691).
We constructed a nomogram that can assess the risk of coGVHD in patients after allo-HSCT and help minimize the irreversible loss of vision caused by the disease in high-risk populations.
建立并验证异体造血干细胞移植(allo-HSCT)后预测慢性眼部移植物抗宿主病(coGVHD)的列线图模型。
本研究纳入了 61 例 allo-HSCT 后至少存活 100 天的患者。采用 LASSO 回归筛选 coGVHD 的危险因素,然后对筛选出的变量进行 logistic 回归分析。建立列线图进一步确认 coGVHD 的危险因素。利用训练集和测试集构建受试者工作特征(ROC)曲线评估预测模型的性能。采用 logistic 回归分析计算比值比(OR)及其 95%置信区间(95%CI)。
61 例患者中,38 例诊断为 coGVHD。我们选择了 5 个纹理特征:淋巴细胞(LYM)(OR=2.26)、血浆凝血酶原时间(PTA)(OR=1.19)、CD3+CD25+细胞(OR=1.38)、CD3+HLA-DR+细胞(OR=0.95)和眼表疾病指数(OSDI)(OR=1.44)。训练集和测试集列线图的 ROC 曲线下面积(AUC)分别为 0.979(95%CI:0.895-1.000)和 0.969(95%CI:0.846-1.000),且训练集(p=0.9949)和测试集(p=0.9691)的 Hosmer-Lemeshow 检验均无统计学意义。
我们构建了一个列线图模型,可以评估 allo-HSCT 后患者发生 coGVHD 的风险,有助于在高危人群中减少疾病导致的不可逆转的视力丧失。