| 构建预测肝细胞肝癌术后CNLC III/IV期复发的网页计算器 |
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| 引用本文： | 黄桂忠,尹鹏飞,林巧红,张建龙.构建预测肝细胞肝癌术后CNLC III/IV期复发的网页计算器[J].现代肿瘤医学,2022,0(12):2197-2201. |
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| 作者姓名： | 黄桂忠 尹鹏飞 林巧红 张建龙 |
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| 作者单位： | 中山大学孙逸仙纪念医院肝胆外科，广东 广州 510000 |
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| 摘 要： | 目的:探讨肝细胞肝癌（hepatocellular carcinoma,HCC）术后出现CNLC III/IV期复发危险因素，并构建线上预测模型。方法:回顾性分析我院2011年1月至2017年12月接受肝癌切除术的289例HCC患者临床及病理资料，基于Logistic回归分析明确HCC患者术后出现CNLC III/IV期复发高危因素，并以多因素回归分析结果为基础构建线上预测模型，通过一致性指数（C指数）、校正曲线及临床决策曲线验证该模型预测能力及临床效能。结果:截止至随访日期，共有158例（54.7%）的HCC患者出现术后复发，其中56例（19.4%）为CNLC III/IV期复发。经过多因素Logistic回归分析得术前NLR≥1.56（OR:2.745,95%CI:1.041~7.240,P=0.041）、肿瘤直径≥5.75 cm（OR:3.664,95%CI:1.612~8.328,P=0.002）、肿瘤低分化（OR:4.197,95%CI:2.027~8.688,P＜0.001）、微卫星灶（OR:3.426,95%CI:1.241~9.460,P=0.017）及微血管侵犯（OR:3.127,95%CI:1.301~7.514,P=0.011）是术后出现CNLC III/IV复发的危险因素，以此为基础建立相应线上预测计算器，该预测模型时间依赖性受试者工作特征曲线下面积(AUC)为0.862，校正C指数为0.850。结论:HCC患者术后出现CNLC III/IV期复发与诸多因素相关，通过本研究所建立的网页计算器，临床医生可快速简便地识别高危人群并尽早予以干预措施，对临床工作具有指导意义。
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| 关 键 词： | 肝细胞肝癌 CNLC分期 复发 预测模型 |
An online calculator predicting recurrence at CNLC III/IV stage of hepatocellular carcinoma after resection |
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| HUANG Guizhong,YIN Pengfei,LIN Qiaohong,ZHANG Jianlong.An online calculator predicting recurrence at CNLC III/IV stage of hepatocellular carcinoma after resection[J].Journal of Modern Oncology,2022,0(12):2197-2201. |
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| Authors: | HUANG Guizhong YIN Pengfei LIN Qiaohong ZHANG Jianlong |
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| Affiliation: | Department of Hepatobiliary Surgery,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Guangzhou 510000,China. |
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| Abstract: | Objective:To identify the independent risk factors of recurrence at CNLC III/IV stage of hepatocellular carcinoma(HCC) after surgery and then construct an online predictive calculator.Methods:289 HCC patients accepting surgery from January 2011 to December 2017 in our hospital were included in this retrospective study.Logistic multivariate regression analysis was conducted to identify high-risk factors of recurrence at CNLC III/IV stage of HCC after primary resection.Based on the results of logistic regression analysis,we constructed an online predictive model.A concordance index (C-index),calibration curve and clinical decision curve analysis (DCA) were used to validate the performance and clinical utility of the model.Results:158 patients suffered from recurrences,and of these,56 cases diagnosed with recurrence at CNLC III/IV stage.Multivariate analysis of logistic model showed that preoperative neutrophil to lymphocyte ratio (NLR≥1.56) (OR:2.745,95%CI:1.041~7.240,P=0.041),tumour size≥5.75 cm (OR:3.664,95%CI:1.612~8.328,P=0.002),poor differentiation (OR:4.197,95%CI:2.027~8.688,P＜0.001),microsatellite lesion (OR:3.426,95%CI:1.241~9.460,P=0.017）and microvascular invasion (OR:3.127,95%CI:1.301~7.514,P=0.011) were high-risk factors of recurrence at CNLC III/IV stage after resection.The area under the time-dependent receiver operating characteristic curve of the developed model was 0.862 with a corrected C index of 0.850.Conclusion:Postoperative CNLC stage III/IV recurrence in HCC patients is associated with many factors.By this easy-to-use online calculator,clinicians could conveniently identify those high risk patients and then provide more personalized therapeutic strategy for them to improve their dismal prognosis. |
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| Keywords: | hepatocellular carcinoma CNLC stage recurrence predictive model |
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