Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1213-1226
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1213
Predictive model for non-malignant portal vein thrombosis associated with cirrhosis based on inflammatory biomarkers
Guo-Le Nie, Jun Yan, Ying Li, Hong-Long Zhang, Dan-Na Xie, Xing-Wang Zhu, Xun Li
Guo-Le Nie, Hong-Long Zhang, Dan-Na Xie, Xing-Wang Zhu, The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
Jun Yan, Ying Li, Xun Li, Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Nie GL and Zhang HL wrote the first draft of the manuscript; Li Y and Yan J established inclusion and exclusion criteria; Xie DN and Zhu XW conducted literature searches; GL N and Zhang HL performed the data analysis and drew tables and pictures; Li Y, Yan J, and Li X reviewed and provided feedback on various drafts of the manuscript and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Hospital of Lanzhou University (LDYYLL2021-286) and was conducted in accordance with the principles of the Declaration of Helsinki.
Informed consent statement: As the study was a retrospective study, the extracted clinical data and laboratory tests were from the electronic case retrieval system of the First Hospital of Lanzhou University. The study was approved by the Ethics Committee of the First Hospital of Lanzhou University (LDYYLL2021-286). The data are a nonymous, and the requirement for informed consent was therefore waived.
Conflict-of-interest statement: The authors reported no financial interests or potential conflicts of interest.
Data sharing statement: Data supporting the findings of this study are available from the author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xun Li, PhD, Chief Physician, Department of General Surgery, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. lxdr21@126.com
Received: October 8, 2023
Peer-review started: October 8, 2023
First decision: January 12, 2024
Revised: January 18, 2024
Accepted: February 23, 2024
Article in press: February 23, 2024
Published online: April 15, 2024
ARTICLE HIGHLIGHTS
Research background

Portal vein thrombosis (PVT) is one of the complications of cirrhosis and one of the major public health concerns. PVT is found incidentally during the natural course of cirrhotic patients, and the formation of PVT is closely related to patient prognosis.

Research motivation

The identification of people at high risk for PVT is crucial for the prevention and treatment of PVT, therefore, it is necessary to develop an early prediction model of the probability of developing PVT in cirrhotic patients to guide clinical decision-making.

Research objectives

Development and validation of a nomogram and network calculator based on clinical blood inflammation markers for early identification of people at high risk of PVT.

Research methods

By 1:1 propensity score matching, 572 eligible patients with cirrhosis were screened and their relevant clinical data were collected. Risk factors associated with the development of PVT were identified using the least absolute shrinkage and selection operator and multivariate logistic regression analysis. Variance inflation factor and correlation matrix plots tested for multicollinearity between variables. Finally, nomograms and network calculators predicting the risk of PVT occurrence were constructed and validated based on the independent risk factors for PVT.

Research results

A total of 572 patients with cirrhosis were included in this study. The final nine parameters identified as independent risk factors for PVT in cirrhosis were etiology, ascites, gastroesophageal varices (GOV), platelet count (PLT), D-dimer (D-D), portal vein diameter (PVD), portal vein velocity (PVV), aspartate aminotransferase-to-neutrophil ratio index (ANRI), and platelet-to-lymphocyte ratio (PLR). The area under the receiver operating characteristic of the constructed nomogram was 0.821 and 0.829 in the training and test groups, respectively. The calibration curves and DCA showed good clinical performance. Finally, the best threshold for the total score of the nomogram was 0.513. The sensitivity and specificity of the best threshold were 0.822 and 0.706, respectively.

Research conclusions

Etiology, ascites, GOV, PLT, D-D, PVD, PVV, ANRI, and PLR were the independent risk factors for PVT in cirrhosis. The constructed nomogram had its excellent clinical performance.

Research perspectives

In this article, we constructed a prediction model about the risk of developing PVT in the natural course of cirrhosis, and also confirmed that inflammatory markers have a good application value in the diagnosis of PVT. A convenient web-based calculator was also constructed to enable the assessment of the risk of developing PVT in patients with cirrhosis.