良性前列腺增生并发膀胱结石的危险因素分析及基于SHAP的可解释性预测模型构建

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Risk factors of bladder stones in patients with benign prostatic hyperplasia and development of a SHAP-based interpretable predictive model

ZHAO Huan，OUYANG Song，DONG Hongchao，WANG Qinzhang （Department of Urology，The First Afiliated Hospital of Shihezi University，Shihezi 8320o08，China）

ABSTRACT：ObjectiveTo explore the independent risk factors of bladder stones （BS）in patients with benign prostatic hyperplasia（BPH），and toconstructa predictive modeland an easy-to-use website.MethodsThe clinicaldataof 460 BPH patients treatedduring Jan.2O22and Jan.2025in theFirst Afiliated Hospital of Shihezi University wereretrospectively analyzed.The independentrisk factorsof BSinthetrainingsetwere identified withunivariate logisticregresionand the Borutaalgorithm，basedonwhicha nomogram was constructed.Thepredictive performanceof the model was evaluated with receiver operatingcharacteristic（ROC）curve，sensitivity，specificity，positive predictivevalue（PPV），negative predictivevalue （NPV），Flindex，calibrationcurveandclinical decisioncurveanalysis（DCA）．Thecontributionof diferentvariables toBS was evaluated with SHapley Additive exPlanations （SHAP）algorithm.A web page was established.ResultsAmong the 460 BPH patients，144 （ 31.3% ）had BS，and 6 independent risk factors were identified，including neutrophil level，urine culture results，intravesical prostaticprotrusion（IPP），urinenitritetestresults，urineleukocytes testresults，andurineocultblood results. In the test set，the area under the ROC curve（AUC） was O.887 （ 95%CI：0.816-0.947; ，sensitivity O.705，specificity 0.968，PPVO.912，NPVO.876，andFl scoreO.795．Calibrationand DCA indicated gooddiscriminationand clinical applicability.SHAP results showed that therisk factors mentioned above were the most important forconcurrent BS.The resultingwebsite（htps：//wutiaowu2.shinyapps.io/bladderrr/）waspubliclyaccessble.ConclusionThe neutrophil level， urinecultureresults，IPP，urinarynitritetestresults，urinaryleukocytes testresults，andurinaryoccult bloodtestresults were identifiedas theindependentrisk factorsof BPHcomplicated withBS.The modeland websitedeveloped basedonthesefactors demonstrate high usability and accuracy，possessing significant clinical value.

KEY WORDS： prostatic hyperplasia; bladder stones; nomogram； prediction model; SHAP algorithm

中图分类号：R694 文献标志码：A DOI：10.3969/j.issn.1009-8291.2025.08.004

良性前列腺增生（benignprostatichyperplasia，BPH）是一种好发于中老年男性的疾病，50岁以上男性的患病率约为 50% ，且这一比例随年龄递增，80岁时可达 90% 左右[1]。（剩余10213字）