Department of Ultrasound, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361003, China.
Dentomaxillofac Radiol. 2024 Jan 11;53(1):43-51. doi: 10.1093/dmfr/twad005.
Accurate distinguishing between immunoglobulin G4-related sialadenitis (IgG4-RS) and primary Sjögren syndrome (pSS) is crucial due to their different treatment approaches. This study aimed to construct and validate a nomogram based on the ultrasound (US) scoring system for the differentiation of IgG4-RS and pSS.
A total of 193 patients with a clinical diagnosis of IgG4-RS or pSS treated at our institution were enrolled in the training cohort (n = 135; IgG4-RS = 28, pSS = 107) and the validation cohort (n = 58; IgG4-RS = 15, pSS = 43). The least absolute shrinkage and selection operator regression algorithm was utilized to screen the most optimal clinical features and US scoring parameters. A model for the differential diagnosis of IgG4-RS or pSS was built using logistic regression and visualized as a nomogram. The performance levels of the nomogram model were evaluated and validated in both the training and validation cohorts.
The nomogram incorporating clinical features and US scoring parameters showed better predictive value in differentiating IgG4-RS from pSS, with the area under the curves of 0.947 and 0.958 for the training cohort and the validation cohort, respectively. Decision curve analysis demonstrated that the nomogram was clinically useful.
A nomogram based on the US scoring system showed favourable predictive efficacy in differentiating IgG4-RS from pSS. It has the potential to aid in clinical decision-making.
由于 IgG4 相关唾液腺炎 (IgG4-RS) 和原发性干燥综合征 (pSS) 的治疗方法不同,准确区分这两种疾病至关重要。本研究旨在构建和验证一种基于超声 (US) 评分系统的列线图,用于区分 IgG4-RS 和 pSS。
本研究共纳入了 193 例在我院就诊的 IgG4-RS 或 pSS 患者,其中 135 例患者纳入训练队列 (IgG4-RS=28 例,pSS=107 例),58 例患者纳入验证队列 (IgG4-RS=15 例,pSS=43 例)。采用最小绝对收缩和选择算子回归算法筛选最佳的临床特征和 US 评分参数。使用逻辑回归构建 IgG4-RS 或 pSS 的鉴别诊断模型,并将其可视化作为列线图。在训练队列和验证队列中评估和验证了列线图模型的性能水平。
纳入临床特征和 US 评分参数的列线图在区分 IgG4-RS 和 pSS 方面具有更好的预测价值,其在训练队列和验证队列中的曲线下面积分别为 0.947 和 0.958。决策曲线分析表明,该列线图具有临床应用价值。
基于 US 评分系统的列线图在区分 IgG4-RS 和 pSS 方面具有良好的预测效果,有可能辅助临床决策。