Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy

Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy Yaling Zhai, Shuaigang Sun, Wenhui Zhang, Huijuan Tian, Zhanzheng Zhao This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4774867/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Mar, 2025 Read the published version in BMC Nephrology → Version 1 posted 8 You are reading this latest preprint version Abstract Background The association between membranous nephropathy (MN) and malignant tumor has long been focused. However, existing studies mostly focused on patients diagnosed of malignant tumors within a limited timeframe (typically defined as 1 year) before or after the diagnosis of MN. Actually, this represents only a subgroup of MN patients complicated with malignant tumors, and those complicated with malignant tumors without a limited period of time haven’t received attention and research. In this study, we aimed to explore the clinicopathologic characteristics of MN patients complicated with malignant tumors, and establish an effective predictive model for identifying the risk of malignant tumors in patients with MN. Methods A total of 194 MN patients with malignant tumors and 604 idiopathic MN patients without malignant tumors were retrospectively recruited in this study. All of the patients were then randomly separated (3:1) into the training cohort (n = 599) and the validation cohort (n = 199). A predictive model was constructed based on regression analysis and the model performance, calibration ability and clinical utility were subsequently assessed via the area under the ROC curve (AUC), calibration curve and decision curve analysis (DCA). Results A predictive model basedd on age, hemoglobin, degree of arteriole injury, glomerular IgG1, IgG2, IgG3, IgG4, and PLA2R deposition were constructed. The predictive model exhibited a diagnostic power of 0.890 and 0.960 in the training and validation cohorts, respectively, and was validated to demonstrate strong calibration capability and clinical utility. Conclusion In this largest cohort with MN and malignant tumors up to date, we constructed a model based on clinical and pathological parameters, to effectively estimate the risk of malignant tumors in patients with MN. This tool aims to assist clinicians in their decision-making process and improve the prognosis for high-risk MN patients by facilitating tumors screening at the time of initial diagnosis. IgG subclasses malignant tumor membranous nephropathy PLA2R predictive model Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 22 Mar, 2025 Read the published version in BMC Nephrology → Version 1 posted Editorial decision: Revision requested 29 Nov, 2024 Reviews received at journal 04 Sep, 2024 Reviewers agreed at journal 14 Aug, 2024 Reviewers invited by journal 13 Aug, 2024 Editor invited by journal 08 Aug, 2024 Editor assigned by journal 08 Aug, 2024 Submission checks completed at journal 08 Aug, 2024 First submitted to journal 20 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4774867","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":348580193,"identity":"7613fd1e-a501-4a27-9c40-f39ac9fa4ed1","order_by":0,"name":"Yaling Zhai","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Yaling","middleName":"","lastName":"Zhai","suffix":""},{"id":348580194,"identity":"40b5ea63-90d8-4d68-af6a-74db158d0923","order_by":1,"name":"Shuaigang Sun","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Shuaigang","middleName":"","lastName":"Sun","suffix":""},{"id":348580195,"identity":"3fff01fe-cdde-4b92-8e9b-5f3aa6e13b0a","order_by":2,"name":"Wenhui Zhang","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Wenhui","middleName":"","lastName":"Zhang","suffix":""},{"id":348580196,"identity":"c1443911-3f6d-4855-86eb-627717fd41a2","order_by":3,"name":"Huijuan Tian","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Huijuan","middleName":"","lastName":"Tian","suffix":""},{"id":348580197,"identity":"c727aec3-3936-4fd8-92f3-8f455cecf685","order_by":4,"name":"Zhanzheng Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABA0lEQVRIiWNgGAWjYDACCSBmbACxeIC4AiFIrJYzJGthbCNCi/zs5mcPf+6wyZP3P3vww8d5dfYGB5gP3uZhsMvDpYVxzjFzA8kzacWGB84lS87cxsZscIAt2ZqHIbkYlxZmiQQzCcO2w4kbG3sMpHm38bAZHOAxk+ZhOJDYgEMLm0T6N4nEtv+JG5t5jH/zzpHgMTjA/w2vFh6JHDOJg20HEuezAQ3nbTCQANrChleLhEROmWRjW3LiBh4eM8sZxxIMJA+zGVvOMUjGqUV+Rvo2yZ9tdonz+88Y3/hQU2fPd7z54Y03FXY4tcCBwQF4iIC5hNSDrCNo6CgYBaNgFIxYAADDEVCvxVYACwAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":true,"prefix":"","firstName":"Zhanzheng","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2024-07-21 01:23:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4774867/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4774867/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12882-025-04053-y","type":"published","date":"2025-03-22T15:58:19+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79120577,"identity":"f11373a2-975d-42d0-9ddc-0ab7c5e628fd","added_by":"auto","created_at":"2025-03-24 16:09:49","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":673565,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4774867/v1_covered_e505caf9-80b2-497a-be3f-f23d64a29cb6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnep","sideBox":"Learn more about [BMC Nephrology](http://bmcnephrol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bnep/default.aspx","title":"BMC Nephrology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"IgG subclasses, malignant tumor, membranous nephropathy, PLA2R, predictive model","lastPublishedDoi":"10.21203/rs.3.rs-4774867/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4774867/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe association between membranous nephropathy (MN) and malignant tumor has long been focused. However, existing studies mostly focused on patients diagnosed of malignant tumors within a limited timeframe (typically defined as 1 year) before or after the diagnosis of MN. Actually, this represents only a subgroup of MN patients complicated with malignant tumors, and those complicated with malignant tumors without a limited period of time haven\u0026rsquo;t received attention and research. In this study, we aimed to explore the clinicopathologic characteristics of MN patients complicated with malignant tumors, and establish an effective predictive model for identifying the risk of malignant tumors in patients with MN.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 194 MN patients with malignant tumors and 604 idiopathic MN patients without malignant tumors were retrospectively recruited in this study. All of the patients were then randomly separated (3:1) into the training cohort (n\u0026thinsp;=\u0026thinsp;599) and the validation cohort (n\u0026thinsp;=\u0026thinsp;199). A predictive model was constructed based on regression analysis and the model performance, calibration ability and clinical utility were subsequently assessed via the area under the ROC curve (AUC), calibration curve and decision curve analysis (DCA).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA predictive model basedd on age, hemoglobin, degree of arteriole injury, glomerular IgG1, IgG2, IgG3, IgG4, and PLA2R deposition were constructed. The predictive model exhibited a diagnostic power of 0.890 and 0.960 in the training and validation cohorts, respectively, and was validated to demonstrate strong calibration capability and clinical utility.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIn this largest cohort with MN and malignant tumors up to date, we constructed a model based on clinical and pathological parameters, to effectively estimate the risk of malignant tumors in patients with MN. This tool aims to assist clinicians in their decision-making process and improve the prognosis for high-risk MN patients by facilitating tumors screening at the time of initial diagnosis.\u003c/p\u003e","manuscriptTitle":"Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-03 12:08:28","doi":"10.21203/rs.3.rs-4774867/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-29T09:53:13+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-04T14:22:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"198362319032639018260443756207054245769","date":"2024-08-14T19:48:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-13T13:07:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-08-08T10:53:07+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-08T10:26:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-08T10:24:48+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nephrology","date":"2024-07-21T01:10:17+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnep","sideBox":"Learn more about [BMC Nephrology](http://bmcnephrol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bnep/default.aspx","title":"BMC Nephrology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f6bb1732-efb3-430d-ae6a-78a8064368e1","owner":[],"postedDate":"September 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-24T16:04:20+00:00","versionOfRecord":{"articleIdentity":"rs-4774867","link":"https://doi.org/10.1186/s12882-025-04053-y","journal":{"identity":"bmc-nephrology","isVorOnly":false,"title":"BMC Nephrology"},"publishedOn":"2025-03-22 15:58:19","publishedOnDateReadable":"March 22nd, 2025"},"versionCreatedAt":"2024-09-03 12:08:28","video":"","vorDoi":"10.1186/s12882-025-04053-y","vorDoiUrl":"https://doi.org/10.1186/s12882-025-04053-y","workflowStages":[]},"version":"v1","identity":"rs-4774867","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4774867","identity":"rs-4774867","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}