A nomogram for bladder pain syndrome/interstitial cystitis based on netrin-1.

Area of Science:

• Urology
• Biomarkers
• Diagnostic modeling

Background:

• Bladder pain syndrome/interstitial cystitis (BPS/IC) presents diagnostic challenges.
• Identifying reliable diagnostic markers for BPS/IC is crucial for effective management.

Purpose of the Study:

• To develop a diagnostic model for BPS/IC by integrating plasma netrin-1 levels with clinical parameters.
• To evaluate the diagnostic accuracy and predictive capability of this novel model.

Main Methods:

• Analysis of plasma netrin-1's independent diagnostic value and correlation with BPS/IC symptom scores.
• Selection of clinical parameters using LASSO regression.
• Construction and validation of a multivariate logistic regression model and a nomogram incorporating netrin-1, assessed via C-index and decision curve analysis (DCA).

Main Results:

• Plasma netrin-1 demonstrated significant independent diagnostic value for BPS/IC (AUC=0.858, sensitivity=85%, specificity=82%).
• The developed nomogram, including age, CD3+/CD4+ T lymphocyte ratio, and netrin-1, achieved a high C-index of 0.882.
• Internal validation confirmed the model's reliability (C-index=0.870), with combined parameters yielding greater clinical utility than netrin-1 alone per DCA.

Conclusions:

• Plasma netrin-1 is a viable diagnostic marker for BPS/IC, correlating with pain.
• The nomogram integrating netrin-1 and clinical data offers high accuracy in predicting BPS/IC.
• Netrin-1 presents potential as a novel therapeutic target for BPS/IC.