Zhang Li, Xiang Zuo-Lin, Zeng Zhao-Chong, Fan Jia, Tang Zhao-You, Zhao Xiao-Mei
Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Oncotarget. 2016 Jan 19;7(3):3587-98. doi: 10.18632/oncotarget.6534.
We developed an efficient microRNA (miRNA) model that could predict the risk of lymph node metastasis (LNM) in hepatocellular carcinoma (HCC). We first evaluated a training cohort of 192 HCC patients after hepatectomy and found five LNM associated predictive factors: vascular invasion, Barcelona Clinic Liver Cancer stage, miR-145, miR-31, and miR-92a. The five statistically independent factors were used to develop a predictive model. The predictive value of the miRNA-based model was confirmed in a validation cohort of 209 consecutive HCC patients. The prediction model was scored for LNM risk from 0 to 8. The cutoff value 4 was used to distinguish high-risk and low-risk groups. The model sensitivity and specificity was 69.6 and 80.2%, respectively, during 5 years in the validation cohort. And the area under the curve (AUC) for the miRNA-based prognostic model was 0.860. The 5-year positive and negative predictive values of the model in the validation cohort were 30.3 and 95.5%, respectively. Cox regression analysis revealed that the LNM hazard ratio of the high-risk versus low-risk groups was 11.751 (95% CI, 5.110-27.021; P < 0.001) in the validation cohort. In conclusion, the miRNA-based model is reliable and accurate for the early prediction of LNM in patients with HCC.
我们开发了一种有效的微小RNA（miRNA）模型，该模型可以预测肝细胞癌（HCC）患者发生淋巴结转移（LNM）的风险。我们首先对192例接受肝切除术后的HCC患者组成的训练队列进行了评估，发现了五个与LNM相关的预测因素：血管侵犯、巴塞罗那临床肝癌分期、miR-145、miR-31和miR-92a。利用这五个具有统计学独立性的因素建立了一个预测模型。在由209例连续的HCC患者组成的验证队列中证实了基于miRNA的模型的预测价值。该预测模型对LNM风险的评分范围为0至8分。使用临界值4来区分高风险组和低风险组。在验证队列中，该模型在5年期间的敏感性和特异性分别为69.6%和80.2%。基于miRNA的预后模型的曲线下面积（AUC）为0.860。在验证队列中，该模型的5年阳性和阴性预测值分别为30.3%和95.5%。Cox回归分析显示，在验证队列中，高风险组与低风险组的LNM风险比为11.751（95%CI，5.110-27.021；P<0.001）。总之，基于miRNA的模型对于HCC患者LNM的早期预测是可靠且准确的。
