Yu Lihua, Liu Xiaoli, Jiang Yuyong, Wang Xinhui, Wang Xianbo, Yang Zhiyun
Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, People's Republic of China.
First Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, People's Republic of China.
Onco Targets Ther. 2020 Nov 6;13:11421-11431. doi: 10.2147/OTT.S275304. eCollection 2020.
Individuals with hepatocellular carcinoma (HCC) are at risk of tumor recurrence after surgical resection, which affects their survival. The aim of the present study was to establish a model for predicting tumor progression in patients with HCC.
To develop and validate the efficacy of a novel prognostic model, a retrospective cohort with HCC (n = 1005) at Beijing Ditan Hospital was enrolled from January 2008 and June 2017. Furthermore, a prospective cohort (n = 77) was recruited to validate the association between thyroid-stimulating hormone (TSH) levels and tumor progression in patients with HCC.
The model used in predicting the progression of HCC included four variables (namely, Barcelona Clinic Liver Cancer [BCLC] stage, presence of portal vein tumor thrombus, alpha-fetoprotein level, and TSH level). The AUROC of the 1-year progression-free survival (PFS) model was 0.755 and 0.753 in the deriving cohort and validation cohort, respectively, and these values were significantly higher than those of the Child-Pugh score, Model for End-stage Liver Disease (MELD), tumor-lymph node-metastasis (TNM) staging system, Okuda classification, and CLIP score. A simple assessment using a nomogram showed the 1-year PFS rate of patients with HCC. In the prospective cohort, the KM curve showed that the high TSH level group had a shorter PFS than the low TSH level ( = 0.001).
The prognostic model of HCC progression was superior to other well-known classical tumor scoring systems. A high TSH level was correlated to poor outcome, particularly those with advanced HCC.
肝细胞癌（HCC）患者在手术切除后有肿瘤复发的风险，这会影响其生存。本研究的目的是建立一个预测HCC患者肿瘤进展的模型。
为了开发和验证一种新型预后模型的有效性，从2008年1月至2017年6月在北京地坛医院纳入了一个HCC回顾性队列（n = 1005）。此外，招募了一个前瞻性队列（n = 77）来验证促甲状腺激素（TSH）水平与HCC患者肿瘤进展之间的关联。
用于预测HCC进展的模型包括四个变量（即巴塞罗那临床肝癌[BCLC]分期、门静脉肿瘤血栓的存在、甲胎蛋白水平和TSH水平）。1年无进展生存（PFS）模型在推导队列和验证队列中的曲线下面积（AUROC）分别为0.755和0.753，这些值显著高于Child-Pugh评分、终末期肝病模型（MELD）、肿瘤-淋巴结-转移（TNM）分期系统奥田分类和CLIP评分。使用列线图进行的简单评估显示了HCC患者的1年PFS率。在前瞻性队列中，Kaplan-Meier曲线显示高TSH水平组的PFS比低TSH水平组短（P = 0.001）。
HCC进展的预后模型优于其他著名的经典肿瘤评分系统。高TSH水平与不良预后相关，尤其是晚期HCC患者。
