Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Oncology and Hepatobiliary Minimally Invasive Interventional Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Br J Radiol. 2021 Feb 1;94(1118):20200163. doi: 10.1259/bjr.20200163. Epub 2020 Dec 22.
This study aimed to develop a predictive risk model for post-ablation hemobilia.
This was a retrospective, multicenter, matched case-control study. The case group comprised patients with hepatocellular carcinoma who developed post-ablation hemobilia ( = 21); the control group ( = 63) comprised patients with hepatocellular carcinoma but no post-ablation hemobilia; for each case, we included three controls matched for age, sex, platelet count, year of ablation therapy, and center. Univariate and multivariate regression analyses were performed to identify the risk factors for hemobilia. A risk score model was developed based on adjusted odds ratios (ORs).
The independent risk factors for occurrence of post-ablation hemobilia were maximum tumor diameter >47 mm [OR = 5.983, 95% CI (1.134-31.551)] and minimum distance from the applicator to the portal trunk ≤8 mm [OR = 4.821, 95% CI (1.225-18.975)]. The risk model was developed using the adjusted ORs; thus a score of 6 was assigned to the former and a score of 5 for the latter. The area under the curve of this risk model was 0.76. Significant hemodynamic instability and inaccurate embolization might increase the risk of recurrence of hemobilia.
Tumor size >47 mm and distance of the applicator from the portal trunk ≤8 mm are independent risk factors for hemobilia. A predictive risk model for post-ablation hemobilia was developed using these risk factors.
This is the first study that developed a risk score model of post-ablation hemobilia. Risk factors of the recurrence of post-ablation hemobilia were also been identified.
本研究旨在建立消融后胆血征的预测风险模型。
这是一项回顾性、多中心、病例对照匹配研究。病例组由发生消融后胆血征的肝细胞癌患者组成（n=21）；对照组（n=63）由未发生消融后胆血征的肝细胞癌患者组成；对每个病例，我们纳入了年龄、性别、血小板计数、消融治疗年份和中心相匹配的 3 个对照。进行单因素和多因素回归分析以确定胆血征的危险因素。基于调整后的比值比（ORs）建立风险评分模型。
消融后胆血征发生的独立危险因素是最大肿瘤直径>47mm[OR=5.983，95%CI（1.134-31.551）]和距施源器至门静脉主干的最短距离≤8mm[OR=4.821，95%CI（1.225-18.975）]。使用调整后的 OR 建立风险模型；因此，前者赋值 6 分，后者赋值 5 分。该风险模型的曲线下面积为 0.76。明显的血流动力学不稳定和不准确的栓塞可能增加胆血征复发的风险。
肿瘤直径>47mm和距门静脉主干的施源器最短距离≤8mm是胆血征的独立危险因素。使用这些危险因素建立了消融后胆血征的预测风险模型。
这是第一项开发消融后胆血征风险评分模型的研究。还确定了消融后胆血征复发的危险因素。
