Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Radiation Oncology, Stanford Medical School, Stanford University, Stanford, California.
J Surg Oncol. 2020 Dec;122(8):1553-1568. doi: 10.1002/jso.26195. Epub 2020 Aug 29.
Inflammation plays an important role in the progression and prognosis of hepatocellular carcinoma (HCC). Our aim is to explore the prognostic value of preoperative and postoperative peripheral lymphocyte differences and to develop a dynamic prognosis nomogram in hepatitis B virus-related HCC patients.
Important indicators related to overall survival (OS) are screened out by Cox proportional hazard models. The receiver operating characteristic curves, decision curve analysis curves, net reclassification improvement, and integrated discrimination improvement were used to evaluate the performance of the model.
Lymphocyte (L) difference was an independent risk factor. It was further verified that the performance of the nomogram was significantly improved after the L difference was incorporated into the nomogram. The nomogram generated had the area under curves of 0.779, 0.775, and 0.793 at 3, 5, and 7 years after surgery, respectively. Our nomogram models showed significantly better performance in predicting the HCC prognosis compared to other models. And online webserver and scoring system table was built based on the proposed nomogram for convenient clinical use.
It is newly found that L difference is an effective predictor of OS, and the nomogram based on this indicator can accurately predict the prognosis of HCC patients.
炎症在肝细胞癌（HCC）的进展和预后中起着重要作用。我们的目的是探讨术前和术后外周血淋巴细胞差异的预后价值，并为乙型肝炎病毒相关 HCC 患者开发一种动态预后列线图。
通过 Cox 比例风险模型筛选出与总生存期（OS）相关的重要指标。使用接受者操作特征曲线、决策曲线分析曲线、净重新分类改善和综合判别改善来评估模型的性能。
淋巴细胞（L）差异是一个独立的危险因素。进一步验证了在列线图中纳入 L 差异后，列线图的性能得到了显著提高。术后 3、5 和 7 年生成的列线图的曲线下面积分别为 0.779、0.775 和 0.793。与其他模型相比，我们的列线图模型在预测 HCC 预后方面表现出明显更好的性能。并基于所提出的列线图构建了在线网络服务器和评分系统表，方便临床使用。
新发现 L 差异是 OS 的有效预测指标，基于该指标的列线图可以准确预测 HCC 患者的预后。
