Predictive Value of Neutrophile Granulocyte Levels and Nomogram Modeling for Postoperative Central Diabetes Insipidus Risk in Patients with Craniopharyngioma

DU Jinwei; GONG Yanyu; SUN Yue; ZHANG Peixiao; JIANG Jin; QU Hong

doi:10.13730/j.issn.2097-2148.2025.09.004

Abstract：Objective To explore the predictive value of peripheral blood inflammatory markers and its nomogram model for postoperative central diabetes insipidus(CDI)in patients with craniopharyngioma.Methods The clinical data of 239 patients with craniopharyngioma admitted to author's hospital from January 2018 to December 2023 were collected.According to the pres-ence or absence of CDI,the patients were divided into CDI occurrence group(n=88)and CDI non-occurrence group(n=151).The clinical data of the two groups were compared,Logistic regression model was used to analyze the influencing factors of CDI in patients with craniopharyngioma after surgery,and the nomogram model was constructed;receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate the predictive value of peripheral blood inflammatory indi-cators and nomogram model for postoperative CDI in patients with craniopharyngioma.Results In the CDI occurrence group,the surgical procedure was transsphenoidal endoscopic resection,the resection range was total resection,the propor-tion of patients with the history of diabetes mellitus,and the inflammatory markers of white blood cell(WBC),neutrophil(NEUT),neutrophil/lymphocyte(NLR),C reactive protein(CRP)and C reactive protein/albumin(CAR)were significantly higher in the CDI non-occurrence group,while the inflammatory markers lymphocyte(LY)and monocytes/lymphocyte(MLR)in CDI occurrence group were significantly lower than that in CDI non-occurrence group(all P＜0.05).Multivariate Logistic re-gression analysis showed that total resection,WBC,NEUT and CAR were independent risk factors for CDI in patients with cra-niopharyngioma(all P＜0.05).the area under the curve(AUC)of the model was 0.963(95％CI:0.940-0.987);the sensi-tivity was 0.890,the specificity was 0.954 and the Youden index was 0.844;the AUC of NEUT was 0.950(95％CI:0.922-0.978).The curve of the nomogram model based on total resection,WBC,NEUT,CAR and the NEUT level curve were above the curves of the total intervention and non-intervention models,which could obtain better net benefits.Conclusion The nomo-gram model and NEUT level can well predict the probability of postoperative CDI.