Development of a Nomogram for Diagnosing Malignant Biliary Strictures: A Retrospective Study

Abstract

Background Diagnosing biliary strictures is a significant clinical challenge. Currently, there is no reliable clinical evaluation system to guide diagnosis and treatment. Aims The aim of this study was to investigate the potential risk factors associated with malignant biliary strictures (MBS) and to develop a nomogram for assessing the malignancy of biliary strictures. Methods Patients with biliary strictures admitted to the First Affiliated Hospital of Nanjing Medical University were included and the medical records of them were analyzed to identify independent risk factors associated with MBS through least absolute shrinkage and selection operator (LASSO) and logistic analysis. Subsequently, a nomogram was established to aid clinical diagnosis. Results The study comprised 602 patients, with 290 patients classified as benign and 312 as malignant. Multivariate analysis demonstrated that symptoms of fever, CA19-9, presence or history of choledocholithiasis, imaging findings of malignancy, and ERCP results indicative of malignancy were identified as independent predictors of MBS, and the AUC value of the nomogram was 0.917 in the training set and 0.897 in the validation set. Conclusions The study identified several independent predictors for determining MBS and constructed a nomogram to assist in the diagnosis of biliary strictures. When the total point of the nomogram was greater than 128.0, the patient was considered to have a high likelihood of MBS.