Liu Qinqin, You Nan, Zhu Jiangqin, Li Jing, Wu Ke, Wang Zheng, Wang Liang, Zhu Yinan, Gu Huiying, Peng Xuehui, Zheng Lu
Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, China.
Department of Biliary-Pancreatic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Front Mol Biosci. 2021 Nov 26;8:722864. doi: 10.3389/fmolb.2021.722864. eCollection 2021.
Transcatheter arterial embolization (TAE) is regarded as an effective treatment for patients with symptomatic hepatic hemangioma. However, few studies have evaluated the efficacy of TAE alone for treating hepatic hemangioma. The aim of this study was to identify the factors that influence the response to TAE and formulate a quantitative nomogram to optimize the individualized management of hepatic hemangioma. We retrospectively studied 276 patients treated with TAE for hepatic hemangioma at our center from January 2011 to December 2019. The full cohort was randomly divided into training and validation cohorts. After assessing the potential predictive factors for the efficacy of TAE in the training cohort, a nomogram model was established and evaluated by discrimination and calibration. During follow-up, the symptom relief rate was 100%. The tumor blood supply ( < 0.001), tumor number ( = 0.004), and tumor size ( = 0.006) were identified as significant predictors of the failure of tumor shrinkage in response to TAE. The nomogram model showed favorable discrimination and calibration, with a C-index of 0.775 (95% CI, 0.705-0.845) in the training cohort, which was further confirmed in the validation cohort (C-index 0.768; 95% CI, 0.680-0.856). The side effects of TAE were relatively minor and included mainly abdominal pain, nausea, vomiting, fever, and the presence of elevated hepatic transaminases. TAE is a safe and effective treatment for symptomatic hepatic hemangioma. The established nomogram performed well for the estimation of the effect of TAE in patients with hepatic hemangioma and can facilitate the selection of patients who would benefit most from the treatment.
经导管动脉栓塞术(TAE)被认为是治疗有症状肝血管瘤患者的一种有效方法。然而,很少有研究评估单纯TAE治疗肝血管瘤的疗效。本研究的目的是确定影响TAE反应的因素,并制定一个定量列线图以优化肝血管瘤的个体化管理。我们回顾性研究了2011年1月至2019年12月在本中心接受TAE治疗肝血管瘤的276例患者。将整个队列随机分为训练队列和验证队列。在评估训练队列中TAE疗效的潜在预测因素后,建立了列线图模型,并通过区分度和校准进行评估。随访期间,症状缓解率为100%。肿瘤血供(<0.001)、肿瘤数量(=0.004)和肿瘤大小(=0.006)被确定为TAE治疗后肿瘤缩小失败的显著预测因素。列线图模型显示出良好的区分度和校准度,训练队列中的C指数为0.775(95%CI,0.705 - 0.845),在验证队列中得到进一步证实(C指数0.768;95%CI,0.680 - 0.856)。TAE的副作用相对较小,主要包括腹痛、恶心、呕吐、发热以及肝转氨酶升高。TAE是治疗有症状肝血管瘤的一种安全有效的方法。所建立的列线图在估计TAE对肝血管瘤患者的疗效方面表现良好,可有助于选择最能从该治疗中获益的患者。