Abstract
BackgroundPrimary nephrotic syndrome (PNS) is a common autoimmune systemic suppressive disease that, if left untreated, can develop into end-stage renal disease in severe cases, seriously threatening the health of patients. This disease is gradually attracting attention, and ultrasound imaging histology is being tried for PNS as a noninvasive examination method; however, ultrasound imaging histology has not yet seen clinical application in the diagnosis of PNS; therefore, this study investigates the value of ultrasound imaging histological features in the diagnosis of PNS. MethodsA total of 126 PNS patients hospitalized in the Nephrology Department of Hangzhou First People's Hospital from January 2016 to November 2020 were collected in the PNS group, and 11 7 volunteers from the physical examination center were in the normal control group (NC group). The 7:3 stratified sampling was divided into training set (171 cases) and validation set (72 cases), 396 imaging omics parameters of the right kidney ultrasound image were extracted, statistical different parameters were selected after dimension reduction, the prediction model was constructed by Logistics regression, and the ROC curve was drawn to evaluate the efficacy of PNS. Results 19 imaging omics parameters were obtained in Least Absolute Shrinkage and Selection Operator (Least Absolute Shrinkage and Selection Operator, LASSO) after dimension reduction, and the constructed model had good efficacy for predicting PNS. The area under the curve of training set was 0.82, the accuracy, specificity, sensitivity, positive predictive value and negative predictive value were 0.75,0.77,0.78 and 0.73; the validation set was 0.84, accuracy, specificity, sensitivity, positive, and ne gative predictive values were 0.76,0.80,0.72,0.79 and 0.74, respectively. ConclusionThe imaging omics parameters of the right kidney have the potential as non-invasive biological markers for PNS diagnosis, and can provide more accurate imaging basis for the diagnosis and treatment of PNS patients.PNS has a rapid onset and severe symptoms, especially the prevalence and incidence of PNS in children (Alfakeekh et al., 2019; Nephrology Group Pediatric Branch of Chinese Medical Association, 2017). Because the kidneys of PNS patients have no specific signs during routine imaging examination, puncture examination is mostly used clinically to determine the pathological type, but puncture is a traumatic examination and a secondary injury to the kidney, so seeking the noninvasive biological markers of PNS is the focus of current research. Imaging omics is a rapidly developing discipline in recent years. The imaging omics studies on kidney at home and abroad mainly include benign and malignant classification of kidney space, pathological classification of clear cell carcinoma, kidney stone research and so on (Farber et al., 2015; Homayounieh et al., 2021; Ursprung et al., 2020a, 2020b), However, imaging studies based on the kidney itself of nephrotic syndrome are still blank. In this study, the author conducted a retrospective study on the imaging omics analysis of the right kidney of PNS patients, and constructed a predictive model, aiming to provide a new method for the accurate diagnosis of PNS.
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