复发性肝细胞癌患者射频消融术后主要并发症预测模型。

A prediction model of major complications after radiofrequency ablation for recurrent hepatocellular carcinoma patients.

机构信息

Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, China.

Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, China; Department of Central Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China.

出版信息

Eur J Radiol. 2021 Jul;140:109635. doi: 10.1016/j.ejrad.2021.109635. Epub 2021 Mar 10.

DOI:10.1016/j.ejrad.2021.109635

PMID:34024632

Abstract

BACKGROUND

Postoperative major complications are potentially fatal to recurrent hepatocellular carcinoma (RHCC) patients. We aimed to construct a prediction model of major complications after RFA for RHCC patients.

METHODS

We retrospectively reviewed the medical records of 407 RHCC patients who underwent RFA as second treatment. Patients were divided into two groups according to the date of RFA: training cohort (277 patients treated in 2010-2016) and validation cohort (130 patients treated in 2017-2019). 23 clinicopathological variables were recorded and analyzed. The logistic regression model was used to build a prediction model.

RESULT

Major complications developed in 3.6 % of RHCC patients after RFA. In the multivariate analysis, tumor adjacent vessels (p = 0.004) and hepatitis C (p = 0.022) were associated with postoperative complications. The prediction model was described as follow: Risk score (major complication) = 5.180 + 3.391tumor location+3.389hepatic etiology, the Youden index was 0.642, the best cut-off value of the model was 8.57 (sensitivity, 78.57 %, specificity, 84.03 %). The area under the receiver operating characteristic curve of the predictive model was 0.85 (95 % CI, 0.82 to 0.88). The validation of the model demonstrated acceptable results, the sensitivity was 80.00 %, specificity was 98.40 %.

CONCLUSIONS

This study developed a simple and reliable prediction model of postoperative major complications after RFA for RHCC patients.

摘要

背景

术后主要并发症可能对复发性肝细胞癌（RHCC）患者有致命危险。我们旨在为 RHCC 患者射频消融（RFA）术后主要并发症建立预测模型。

方法

我们回顾性分析了 407 例 RHCC 患者的病历，这些患者均接受了 RFA 作为二线治疗。根据 RFA 日期将患者分为两组：训练队列（2010-2016 年接受治疗的 277 例患者）和验证队列（2017-2019 年接受治疗的 130 例患者）。记录并分析了 23 个临床病理变量。使用逻辑回归模型建立预测模型。

结果

RHCC 患者 RFA 后主要并发症发生率为 3.6%。多因素分析显示，肿瘤毗邻血管（p=0.004）和丙型肝炎（p=0.022）与术后并发症相关。预测模型如下：风险评分（主要并发症）=5.180+3.391肿瘤位置+3.389肝脏病因，约登指数为 0.642，模型最佳截断值为 8.57（敏感度 78.57%，特异度 84.03%）。预测模型的受试者工作特征曲线下面积为 0.85（95%CI，0.82 至 0.88）。模型验证结果可接受，敏感度为 80.00%，特异度为 98.40%。