Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), No. 17 Panjiayuannanli, Chaoyang District, Beijing, 100021, China.
J Transl Med. 2021 Jul 6;19(1):293. doi: 10.1186/s12967-021-02940-0.
This is the first study to build and evaluate a predictive model for early relapse after R0 resection in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI).
The consecutive HCC patients with MVI who underwent hepatectomy in Cancer Hospital of Chinese Academy of Medical Science from Jan 2014 to June 2019 were retrospectively enrolled and randomly allocated into a derivation (N = 286) and validation cohort (N = 120) in a ratio of 7:3. Cox regression and Logistic regression analyses were performed and a predictive model for postoperative early-relapse were developed.
A total of 406 HCC patients with MVI were included in our work. Preoperative blood alpha-fetoprotein (AFP) level, hepatitis B e antigen (HBeAg) status, MVI classification, largest tumor diameter, the status of serosal invasion, number of tumors, and the status of satellite nodules were incorporated to construct a model. The concordance index (C-index) was 0.737 and 0.736 in the derivation and validation cohort, respectively. The calibration curves showed a good agreement between actual observation and nomogram prediction. The C-index of the nomogram was obviously higher than those of the two traditional HCC staging systems.
We have developed and validated a prediction model for postoperative early-relapse in HCC patient with MVI after R0 resection.
这是第一项构建和评估伴有微血管侵犯（MVI）的肝细胞癌（HCC）患者 R0 切除术后早期复发预测模型的研究。
回顾性纳入 2014 年 1 月至 2019 年 6 月在中国医学科学院肿瘤医院接受肝切除术的连续 HCC 伴 MVI 患者，并按照 7:3 的比例随机分配到推导队列（N=286）和验证队列（N=120）。进行 Cox 回归和 Logistic 回归分析，并建立术后早期复发的预测模型。
本研究共纳入 406 例伴有 MVI 的 HCC 患者。术前血液甲胎蛋白（AFP）水平、乙型肝炎 e 抗原（HBeAg）状态、MVI 分级、最大肿瘤直径、浆膜侵犯状态、肿瘤数量和卫星结节状态被纳入模型构建。推导和验证队列的一致性指数（C-index）分别为 0.737 和 0.736。校准曲线显示实际观察值与列线图预测值之间具有良好的一致性。该列线图的 C-index 明显高于两个传统的 HCC 分期系统。
我们已经开发并验证了一种用于伴有 MVI 的 HCC 患者 R0 切除术后术后早期复发的预测模型。
