Gland surgery最新文献

{"title":"The differences between unilateral multifocality and bilateral multifocality in papillary thyroid carcinoma: a retrospective cohort study.","authors":"Zhujuan Wu, Hao Gong, Yuhan Jiang, Tianyuchen Jiang, Anping Su","doi":"10.21037/gs-24-147","DOIUrl":"10.21037/gs-24-147","url":null,"abstract":"<p><strong>Background: </strong>The differences between unilateral multifocality and bilaterality in papillary thyroid carcinoma (PTC) are not fully understood. This study aimed to investigate the differences between unilateral multifocal PTC (UMPTC) and bilateral multifocal PTC (BMPTC).</p><p><strong>Methods: </strong>Retrospective data analysis was done on 503 individuals who underwent complete thyroidectomy for PTC. Patients were classified into subgroups according to the type of multifocality including the UMPTC and the BMPTC. The relationships of demographic and clinicopathological features among these groups were analyzed.</p><p><strong>Results: </strong>The patients were divided into the UMPTC group (n=117) and the BMPTC group (n=386). Among them, the BMPTC group was further divided into the N1-BMPTC group (261 cases with one lesion on each thyroid lobe) and the N2-BMPTC group (125 cases with one or more lesions on one lobe and two or more lesions on the other lobe). The maximum tumor diameter (MTD), in the BMPTC group, N1-BMPTC group, and N2-BMPTC group were larger than that in the UMPTC group. The recurrence rate of the N1-BMPTC group was higher than that of the UMPTC group. There were no significant differences in other clinicopathological characteristics [gender, age, body mass index (BMI), presence of Hashimoto's thyroiditis, presence of thyroid nodules, occurrence of capsular invasion, occurrence of extrathyroidal extension, occurrence of lymph node metastasis, and the American Joint Committee on Cancer (AJCC) staging]. The N1-BMPTC group was associated with lymph node metastasis and tumor recurrence. In addition, the disease-free survival (DFS) rates showed the N1-BMPTC group having the lowest DFS rate among the UMPTC, N1-BMPTC, and N2-BMPTC groups.</p><p><strong>Conclusions: </strong>Patients with N1-BMPTCs have a higher recurrence rate than those with other kinds of multifocal PTC.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1684-1692"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes in patients with papillary thyroid cancer undergoing radiofrequency ablation of metastatic lymph nodes.","authors":"Alexandra LaForteza, Emily Persons, Mohammad Hussein, Xinyi Luo, Peter P Issa, Jessan Jishu, Mohamed Shama, Eman Toraih, Emad Kandil","doi":"10.21037/gs-24-285","DOIUrl":"10.21037/gs-24-285","url":null,"abstract":"<p><strong>Background: </strong>Lymph node metastases in papillary thyroid cancer (PTC) increases recurrence risk and negatively impact survival. Traditional treatments like re-operation and radioactive iodine (RAI) have downsides. Radiofrequency ablation (RFA) is an emerging non-surgical therapeutic option, but there is seldom data on its efficacy and safety specifically for metastatic lymph nodes. We aimed to evaluate clinical outcomes of RFA applied to cervical lymph nodes in patients with PTC metastasis in North American population.</p><p><strong>Methods: </strong>This was a single-institution retrospective analysis of 68 PTC patients with lymph nodes who underwent percutaneous RFA from January 2020 to December 2022. Volume reduction ratio (VRR), changes in thyroglobulin (Tg) levels, lymph node regrowth rate, and complications were assessed. Treatment response and outcomes were analyzed.</p><p><strong>Results: </strong>Median lymph node maximum diameter was 12.9 mm and median volume was 0.27 mL at baseline. After RFA, median VRR was 79.5% [interquartile range (IQR), 50-89.7%]. Post-RFA, Tg to an average of 0.2 ng/mL (IQR, 0-0.6 ng/mL). In the 19 patients (27.9%) with undetectable Tg after RFA, median VRR was 86% (IQR, 73-94%). Quantitative Tg decrease strongly correlated with VRR percentage (r=0.82, P<0.001). Lymph node regrowth was seen in 5 patients (7.4%) over median 18 months follow-up. Only one patient experienced transient thermal injury associated with Horner's syndrome and symptoms resolved within 1 month.</p><p><strong>Conclusions: </strong>In patients with PTC and metastatic cervical lymph nodes, RFA provided marked volume reduction and meaningful biochemical response without major complications. Excellent radiographic control was achieved in most patients. RFA demonstrates early promise as an emerging non-surgical therapeutic option for PTC patients with metastatic lymph nodes.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1752-1758"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-induced increase in CD47 expression in epithelial ovarian cancer.","authors":"Ling Zhao, Xueqin Wang, Haining Liu, Jinghe Lang","doi":"10.21037/gs-24-400","DOIUrl":"10.21037/gs-24-400","url":null,"abstract":"<p><strong>Background: </strong>Epithelial ovarian cancer (EOC) remains the most lethal gynecological malignancy with limited treatment options. CD47 is a critical immune checkpoint for tumor immune evasion and has been targeted in various clinical trials. This study aimed to assess the impact of chemotherapy on CD47 expression in EOC in order to determine the potential and optimal timing of CD47-targeted therapy in ovarian cancer. We analyzed the expression of CD47 in ovarian cancer and the effect of chemotherapy on the expression of CD47 in ovarian cancer tissues. Furthermore, we investigated the effect of chemotherapy on the expression of CD47 in ovarian cancer cells.</p><p><strong>Methods: </strong>CD47 expression was examined using immunohistochemistry (IHC) of specimens from 78 patients with EOC who underwent neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) with paired tissue specimens obtained before and after NACT. A retrospective review of the medical records was conducted to correlate demographic and survival data. Subsequently, we employed reverse transcription quantitative polymerase chain reaction (RT-qPCR) and flow cytometry analysis to examine and compare <i>CD47</i> expression across human ovarian surface epithelial cell line (HOSE), SKOV3, and ES2 cells and to characterize the changes in CD47 expression in SKOV3 and ES2 cells after cisplatin treatment.</p><p><strong>Results: </strong>CD47 expression was observed in 63 out of 78 (80.8%) cases before NACT. The expression of CD47 was not associated with the clinicopathological characteristics or the prognosis of patients with EOC. After three cancer specimens were excluded due to the absence of cancer cells following NACT, Wilcoxon exact tests of 75 pairs of matched specimens indicated that the expression of CD47 increased after chemotherapy (P=0.006). <i>CD47</i> was expressed at varying levels in HOSE ovarian epithelial cells and SKOV3 and ES2 ovarian cancer cells. Notably, the <i>CD47</i> messenger RNA (mRNA) expression of HOSE cells was observed to be lower than that of the SKOV3 and ES2 ovarian cancer cells (P<0.001). Following treatment with cisplatin, RT-qPCR indicated an increase in <i>CD47</i> mRNA expression in SKOV3 and ES2 cells (P<0.001). Flow cytometry revealed a notable elevation in the cell surface CD47 protein mean fluorescence intensity of cisplatin-treated SKOV3 and ES2 cells (P<0.001).</p><p><strong>Conclusions: </strong>CD47 is highly expressed in ovarian cancer, and NACT increases the expression of CD47, which may contribute to tumor immune evasion. It is possible that platinum-based chemotherapy may result in elevated <i>CD47</i> mRNA expression and cell surface CD47 protein expression.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1770-1784"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory parameters-based logistic regression models for rapid screening of thyroid nodules.","authors":"Mo Liu, Jing Zhao, Jiayi Zhang, Rui Zhang","doi":"10.21037/gs-24-227","DOIUrl":"10.21037/gs-24-227","url":null,"abstract":"<p><strong>Background: </strong>The increasing incidence of thyroid nodules (TNs) are placing mounting pressure on radiologists. Our study aimed to evaluate the effectiveness of laboratory parameters in the detection of benign and malignant TNs and develop early diagnosis logistic regression models by using the laboratory parameters.</p><p><strong>Methods: </strong>This study was conducted from December 2016 to July 2022 at Beijing Chaoyang Hospital. Totals of 251 healthy individuals, 176 patients with benign TNs (BTNs), and 302 patients with malignant TNs (MTNs) were enrolled. Univariate and multivariate logistic regression analyses were performed to find the meaningful laboratory factors of TNs, and subsequently, prediction models were established. Sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis were applied to evaluate the predictive value of the regression equations. We also compared the expression levels of meaningful indexes in different types of individuals. The models were verified by the validation cohort.</p><p><strong>Results: </strong>Based on the meaningful laboratory factors selected by regression analysis, for predicting patients with BTNs and MTNs in healthy individuals, the diagnostic models were Logit(P) = -2.525 × high density lipoprotein cholesterol (HDL-C) + 1.515 × glucose (Glu) + 0.003 × total triiodothyronine (TT3) - 4.607 × free triiodothyronine (FT3) - 0.81 × serum thyroid stimulating hormone (sTSH) + 8.585 and Logit(P) = -2.789 × HDL-C + 0.035 × lipoprotein [Lp(a)] + 1.141 × Glu + 0.054 × antithyroglobulin antibody (Anti-Tg) - 1.931 × FT3 - 0.341 × sTSH + 3.757. Ideally, the two models showed high area under the curve (AUC) values. For distinguishing patients with BTNs and MTNs, the diagnostic model was Logit(P) = -0.303 × Glu + 0.335 × sTSH + 1.535. However, this model had a relatively low AUC.</p><p><strong>Conclusions: </strong>Our research shows that TNs are associated with laboratory indexes about metabolism of Glu and lipid, thyroid function, albumin (ALB), mean corpuscular hemoglobin (MCH), and platelet (PLT). In routine physical examination and early screening of TNs, laboratory parameters-based logistic regression models are recommended.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 10","pages":"1673-1683"},"PeriodicalIF":1.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and fracture events analysis and intervention strategies in patients undergoing parathyroidectomy with secondary hyperparathyroidism.","authors":"Suyi Xu, Danni Xu, Jun Wu, Jianwen Fan, Marti Manyalich-Blasi, Huafen Wang","doi":"10.21037/gs-24-391","DOIUrl":"https://doi.org/10.21037/gs-24-391","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD), especially end-stage renal disease (ESRD), is the most common cause of secondary hyperparathyroidism (SHPT), and SHPT is the most severe complication of ESRD. This study aimed to analyze the influencing factors of cardiovascular and fracture events in patients with SHPT which are the leading causes of death in patients with CKD, and provide a reference for selecting patients for whom surgery is more suitable.</p><p><strong>Methods: </strong>Patients who underwent parathyroidectomy (PTX) for SHPT at The First Affiliated Hospital, Zhejiang University School of Medicine from September 2021 to April 2024 were selected as the study object, with the inclusion and exclusion criteria as followed. They were divided into rural and urban residents for comparison as a cross-sectional study. The study evaluated the comorbidities, socioeconomic status, and postoperative complications diagnosed by radiography of patients undergoing surgery for SHPT.</p><p><strong>Results: </strong>A total of 119 patients were included, among whom, 71 were from rural areas and 48 were from urban areas. Compared with urban residents, rural residents had poorer economic conditions, a longer interval from disease onset to PTX, and a higher incidence of cardiovascular and fracture events and concurrent nephrolithiasis, all of which were statistically significant. Multivariate analysis indicated that place of residence, age, and duration of uremia were independent risk factors of cardiovascular/fracture events.</p><p><strong>Conclusions: </strong>Medical staff in ESRD outpatient clinics should pay attention to patients with SHPT. ESRD patients should have better surveillance especially for rural, elder and poor phosphorus control patients, and promptly assess surgical intervention measures.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1650-1658"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centralization of adrenal surgeries and improved surgeon volume outcomes.","authors":"Diluka Pinto, Titus Cvasciuc, Rajeev Parameswaran","doi":"10.21037/gs-24-201","DOIUrl":"https://doi.org/10.21037/gs-24-201","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1662-1664"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic prediction of breast cancer patients using machine learning models: a retrospective analysis.","authors":"Xuchun Song, Jiebin Chu, Zijie Guo, Qun Wei, Qingchuan Wang, Wenxian Hu, Linbo Wang, Wenhe Zhao, Heming Zheng, Xudong Lu, Jichun Zhou","doi":"10.21037/gs-24-106","DOIUrl":"https://doi.org/10.21037/gs-24-106","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a common and complex disease, with various clinical features affecting prognosis. Accurate prediction of prognosis is essential for guiding personalized treatment strategies. This study aimed to develop machine learning models for predicting prognosis in breast cancer patients using retrospective data.</p><p><strong>Methods: </strong>A total of 6,477 patients from Affiliated Sir Run Run Shaw Hospital were included, and their electronic medical records (EMRs) were thoroughly examined to identify 15 clinical features significantly associated with breast cancer survival. We employed eight different machine learning algorithms, including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGBoost), to develop and evaluate the predictive performance of the models. In addition, to investigate the sensitivity of different training/testing set radio to model performance, we examined five sets of ratios: 50:50, 60:40, 70:30, 80:20, 90:10.</p><p><strong>Results: </strong>Among these models, XGBoost demonstrated the highest performance with receiver operating characteristic (ROC) area under the curve (AUC) of 0.813, accuracy of 0.739, sensitivity of 0.815, and specificity of 0.735. Further statistical analysis identified several significant predictors of prognosis, including age, tumor size, lymph node status, and hormone receptor status. The XGBoost model was found to exhibit superior predictive power compared to established prognostic models such as the Nottingham Prognostic Index (NPI) and Predict Breast. Based on the successful performance of the XGBoost model, we developed a prognosis prediction tool specifically designed for breast cancer, providing valuable insights to clinicians, and aiding them in making informed treatment decisions tailored to individual patients.</p><p><strong>Conclusions: </strong>Our study highlights the potential of machine learning models in accurately predicting prognosis for breast cancer patients, ultimately facilitating personalized treatment strategies. Further research and validation are warranted to fully integrate these models into clinical practice.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1575-1587"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics and deep learning for large volume lymph node metastasis in papillary thyroid carcinoma.","authors":"Zhongkai Ni, Tianhan Zhou, Hao Fang, Xiangfeng Lin, Zhiyu Xing, Xiaowen Li, Yangyang Xie, Lihua Hong, Shifei Huang, Jinwang Ding, Hai Huang","doi":"10.21037/gs-24-308","DOIUrl":"https://doi.org/10.21037/gs-24-308","url":null,"abstract":"<p><strong>Background: </strong>Thyroid cancer is prone to early lymph node metastasis (LNM), and patients with large volume LNM (LVLNM) tend to have a poorer prognosis. The aim of this study was to predict LVLNM in before surgery based on radiomics and deep learning (DL).</p><p><strong>Methods: </strong>A multicenter retrospective study was performed, including 854 papillary thyroid carcinoma (PTC) patients from three centers. Radiomics features were extracted. Logistic regression (LR), support vector machine (SVM), K-nearest neighbors (KNN), multi-layer perceptron (MLP), random forest (RF), ExtraTrees, extreme gradient boosting (XGBoost), and light gradient boosting machine (LightGBM) algorithms were used to construct radiomics models. AlexNet, DenseNet121, inception_v3, ResNet50, and transformer algorithms were used to construct DL models. The receiver operating characteristic (ROC) curve was employed to select the better-performing model. A combined model was then created by merging radiomics features and DL features. The least absolute shrinkage and selection operator (LASSO) method was utilized to identify metabolites and radiomics features with non-zero coefficients. The performance of the models was evaluated using area under the curve (AUC), accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and F1-score.</p><p><strong>Results: </strong>A total of 1,357 radiomics features were extracted. Among the radiomics models, the ExtraTrees model demonstrated the optimal diagnostic capabilities with an AUC of 0.787 [95% confidence interval (CI): 0.715-0.858], and DenseNet121 DL model demonstrated the optimal diagnostic capabilities with an AUC of 0.766 (95% CI: 0.683-0.848). Furthermore, the combined model, named the Thy-DL-Radiomics model, exhibited an AUC of 0.839 (95% CI: 0.758-0.920) in the internal validation set and 0.789 (95% CI: 0.718-0.859) in the external validation set.</p><p><strong>Conclusions: </strong>A radiomics-DL features integrated model can predict LVLNM in PTC patients and provide guidance for personalized treatment.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1639-1649"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spleen-preserving distal pancreatectomy for intraductal papillary mucinous neoplasm.","authors":"Katsunori Sakamoto","doi":"10.21037/gs-24-150","DOIUrl":"https://doi.org/10.21037/gs-24-150","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1665-1669"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The establishment and validation of a clinical prediction model for postoperative biliary fistula after pancreaticoduodenectomy.","authors":"Zhengrong Ou, An Yan, Weidong Zhu","doi":"10.21037/gs-24-174","DOIUrl":"https://doi.org/10.21037/gs-24-174","url":null,"abstract":"<p><strong>Background: </strong>At present, pancreaticoduodenectomy (PD) is a classic surgical treatment for benign and malignant tumors around ampulla. The operation is complicated and postoperative complications are frequent. Biliary fistula is the most common anastomotic fistula after pancreatic fistula. Our objective is to analyze the risk factors for biliary fistula after PD and to construct a nomogram to predict biliary fistula after PD.</p><p><strong>Methods: </strong>The clinical data of a total of 196 patients who underwent PD from March 2014 to March 2024 in Yueyang Hospital Affiliated to Hunan Normal University and The Third Xiangya Hospital of Central South University were retrospectively analyzed. The number of included patients was divided in the ratio of 7:3 using the random split method, with 130 patients in the training set and 66 patients in the validation set. Predictors were screened and a nomogram prediction model was constructed by one-way logistic regression analysis, Lasso regression analysis and multifactorial logistic regression analysis. The discriminative ability, consistency and clinical effectiveness of the models were assessed by area under the curve (AUC) of the working characteristics of the subjects, calibration curve and decision curve analysis (DCA).</p><p><strong>Results: </strong>The results of multifactorial logistic regression analysis showed that diabetes, low albumin, postoperative gastroparesis, abdominal bleeding, abdominal infection, and postoperative pancreatic fistula were the independent risk factors for biliary fistula after PD (P<0.05). The AUC of the column-line graph prediction model constructed from the above factors was 0.807 [95% confidence interval (CI): 0.652-0.962] in the training set and 0.782 (95% CI: 0.517-1.000) in the validation set, suggesting that the diagnostic efficacy of the model was better, and the calibration curves plotted in the training and validation sets were closer to the standard curves, suggesting that the model consistency was better. The plotted DCA curves also indicated a significant positive net gain.</p><p><strong>Conclusions: </strong>The nomogram prediction model constructed by diabetes, albumin, postoperative gastroparesis, abdominal bleeding, abdominal infection, and postoperative pancreatic fistula can well identify high-risk patients with postoperative biliary fistula (POBF) in PD, which has a good clinical application value.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"13 9","pages":"1605-1618"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}