Development and validation of a diagnostic model for the identification of chronic ocular graft-versus-host disease (oGVHD).
Development and validation of a diagnostic model for the identification of chronic ocular graft-versus-host disease (oGVHD).
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DOI：
10.3389/fmed.2023.1277194
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发表时间：
2023
影响因子：
3.9
通讯作者：
Hong, Jing
中科院分区：
文献类型：
--
作者：
Shen, Zhan;Hu, Bohao;Tao, Liyuan;Ma, Jiao;Peng, Rongmei;Zhao, Yinghan;Hong, Jing
关键词：
验证国际慢性眼部移植物抗宿主病(ICCGVHD)组诊断标准，建立简便、可靠的诊断模型，用于慢性移植物抗宿主病的快速诊断。本研究于2020年7月至2021年2月在北京大学第三医院角膜与眼表疾病专科门诊接受异基因造血干细胞移植(allo-HSCT)的患者180例(355只眼)。慢性移植物抗宿主病占76.06%(279/355)。眼表疾病指数评分、角膜荧光素染色、泪液破裂时间、Schirmer眼底检查评分、结膜评分、泪液半月板高度、非眼部移植物抗宿主病累及器官等6项眼科检查与对照组比较，差异有统计学意义(p <； 0.05)。多元Logistic回归分析(向后LR算法)显示，CFS(OR = 2.71(1.92~3.81)，p <； 0.001)、Schirmer氏评分(OR = 0.83(0.76~0.91)，p <； 0.001)和结膜评分(OR = 1.96(1.13~3.42)，p = 0.031)对慢性移植物抗宿主病有诊断意义。建立了慢性移植物抗宿主病(OGVHD)的正常图，并使用内部验证队列(118只眼)检验了其性能。在发展和内部验证队列中，三变量诺模图的曲线下面积(AUC)分别为0.976(95%CI(0.959-0.992)，p <； 0.01)和0.945(95%CI(0.904-0.986)，p <； 0.01)。这种基于ICCGVHD标准的简明的三变量诺模图可以作为快速筛查慢性移植物抗宿主病的一种简单、可靠的工具。
To verify the International Chronic Ocular Graft-Versus-Host Disease (ICCGVHD) Group diagnostic criteria and establish an easy-to-use and reliable diagnosis model for quick identification of chronic oGVHD. This study included 180 patients (355 eyes) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) and visited the Peking University Third Hospital Cornea and Ocular Surface Disease Specialist Clinic from July 2020 to February 2021. The proportion of chronic oGVHD was 76.06% (279/355). Five complaints, including eye dryness, photophobia, foreign body sensation, eye redness, and burning sensation; six ophthalmic examinations, including Ocular Surface Disease Index (OSDI) score, corneal fluorescein staining (CFS), tear break-up time (TBUT), Schirmer’s test score without anesthesia, conjunctival score, tear meniscus height, and non-ocular GVHD-involved organs were significantly different between patients with chronic oGVHD and control group (p < 0.05). Binary logistic regression (backward LR algorithm) selection demonstrated that three variables retained diagnostic significance for chronic oGVHD: CFS (OR = 2.71 (1.92–3.81), p < 0.001), Schirmer’s test score without anesthesia (OR = 0.83 (0.76–0.91), p < 0.001), and conjunctival score (OR = 1.96 (1.13–3.42), p = 0.031). A nomogram for the identification of chronic oGVHD was developed, and its performance was examined using an internal validation cohort (118 eyes). The areas under the curve (AUCs) for the three-variable-based nomogram were 0.976 (95% CI (0.959–0.992), p < 0.01) and 0.945 (95% CI (0.904–0.986), p < 0.01) in the development and internal validation cohorts, respectively. This concise three-variable-based nomogram based on ICCGVHD criteria could serve as an easy-to-use and reliable tool for rapid screening of chronic oGVHD.
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影响因子：
2.8
作者：
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通讯作者：
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影响因子：
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