Construction and validation of a nomogram model for predicting hypopituitarism after endoscopic transsphenoidal resection of non-functional pituitary macroadenoma
WANG Fei
FU Xiushu
CHEN Kaining
QUAN Huibiao
Abstract：Objective To establish the nomogram model for predicting the risk of hypopituitarism(HAP)after endo-scopic transsphenoidal resection of non-functional pituitary macroadenoma(NFPMA),and to verify the efficacy of this model.Methods Totally 103 patients with NFPMA who underwent endoscopic transsphenoidal resection were selected.According to the pituitary function one year after surgery,they were divided into the HAP group(n=38)and normal anteri-or pituitary function group(n=65).Basic information,medical history,blood lipids,blood glucose results,compression symptom scores,endocrine symptom scores,pituitary-target gland hormone levels,pituitary imaging characteristics includ-ing tumor size and invasiveness scores,postoperative complications,and pathological features were collected for analysis.Univariate and multivariate Logistic regression models were used to analyze the risk factors for HAP after endoscopic transs-phenoidal resection of NFPMA.We constructed a nomogram model based on the risk factors of HAP after endoscopic trans-sphenoidal resection of NFPMA.The predictive performance of the nomogram model was using the receiver operating char-acteristic(ROC)curve.Results Four risk factors of HAP after endoscopic transsphenoidal resection of NFPMA were se-lected based on the univariate and multivariate Logistic regression models:HbA1c,diameter of the pituitary,invasive score,and central diabetes insipidus.The Logictic regression equation for predicting the risk of HAP after endoscopic transphenoidal resection of NFPMA was:logit(P)=-6.309+0.333×HbA1c+0.817×maximum diameter of the pituitary+0.532×invasive score+3.42×central diabetes insipidus(yes=1,no=0).We established its nomogram model through the R4.2.0 software.The area under the ROC curve was 0.842(95 CI:0.763-0.920),with the sensitivity of 81.6%and the specificity of 76.9%.Conclusions HbA1c,maximum diameter of the pituitary,invasive score,and central dia-betes insipidus are risk factors of HAP after endoscopic transsphenoidal resection of NFPMA.The nomogram model based on these predictors can effectively predict the risk of HAP.
Keywords：non-functioning pituitary macroadenomashypofunction of anterior pituitarytranssphenoidal resec-tionpredictive model
Publication Date：2025-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 19-23 )