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根治性肝切除术后乙型肝炎病毒相关肝细胞癌早期复发的列线图模型。

A nomogram model for early recurrence of HBV-related hepatocellular carcinomas after radical hepatectomy.

机构信息

Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Division of Liver Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

出版信息

Front Endocrinol (Lausanne). 2024 Sep 2;15:1374245. doi: 10.3389/fendo.2024.1374245. eCollection 2024.

Abstract

BACKGROUND

To identify the risk factors and construct a predictive model for early recurrence of hepatitis B virus(HBV-)- related hepatocellular carcinomas(HCCs) after radical resection.

DATA AND METHODS

A total of 465 HBV-related HCC patients underwent radical resections between January 1, 2012 and August 31, 2018.Their data were collected through the inpatient information management system of the First Affiliated Hospital of University of Science and Technology of China. Survival and subgroup analyses of early recurrence among male and female patients were performed using Kaplan-Meier curves. The independent risk factors associated with early postoperative tumor recurrence were analyzed using multivariate Cox proportional hazards regression model. Based on these independent risk factors, a risk function model for early recurrence was fitted, and a column chart for the prediction model was drawn for internal and external validation.

RESULTS

A total of 181 patients developed early recurrences, including 156 males and 25 females. There was no difference in the early recurrence rates between males and females. Tumor diameters>5cm, microvascular invasion and albumin level<35 g/L were independent risk factors for early recurrence. A nomogram for the early recurrence prediction model was drawn; the areas under the curve for the model and for external verification were 0.638 and 0.655, respectively.

CONCLUSION

Tumor diameter>5 cm, microvascular invasion, and albumin level<35 g/L were independent risk factors for early recurrence. The prediction model based on three clinical indicators could predict early recurrence, with good discrimination, calibration, and extrapolation.

摘要

背景

为了确定乙型肝炎病毒(HBV)相关肝细胞癌(HCC)根治性切除术后早期复发的危险因素,并构建预测模型。

资料与方法

回顾性分析 2012 年 1 月 1 日至 2018 年 8 月 31 日期间在我院行根治性切除术的 465 例 HBV 相关 HCC 患者的临床资料,采用 Kaplan-Meier 曲线进行男性和女性患者的生存及亚组分析,多因素 Cox 比例风险回归模型分析与术后早期肿瘤复发相关的独立危险因素。基于这些独立危险因素,拟合早期复发风险函数模型,并绘制预测模型的列线图,用于内部和外部验证。

结果

共 181 例患者发生早期复发,其中男性 156 例,女性 25 例,男性和女性的早期复发率无差异。肿瘤直径>5cm、微血管侵犯和白蛋白水平<35g/L 是早期复发的独立危险因素。绘制了早期复发预测模型的诺莫图,模型内部验证和外部验证的曲线下面积分别为 0.638 和 0.655。

结论

肿瘤直径>5cm、微血管侵犯和白蛋白水平<35g/L 是早期复发的独立危险因素。基于这三个临床指标的预测模型可以预测早期复发,具有良好的区分度、校准度和外推度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8b/11402705/ded51ba9324e/fendo-15-1374245-g001.jpg

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