Zhou Liuxin, Ren Li, Yu Wenhao, Qi Mengjian, Yuan Jiaqi, Wang Wen, Su Xiaoxia, Yin Fengjiao, Deng Manjun, Wang Haijiu, Long Hongmu, Zeng Jiangchao, Yu Jiajian, Fan Haining, Wang Zhixin
Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
Department of Hepatopancreatobiliary Surgery, The Chongqing University Fuling Hospital, Fuling, Chongqing, China.
Front Oncol. 2022 Nov 16;12:961194. doi: 10.3389/fonc.2022.961194. eCollection 2022.
This study aimed to investigate the clinical characteristics and risk factors of patients with hepatocellular carcinoma (HCC) with extrahepatic metastases (EHM) and to establish an effective predictive nomogram.
Clinical and pathological data from 607 patients with hepatocellular carcinoma admitted to the Affiliated Hospital of Qinghai University between 1 January 2015 and 31 May 2018 were documented, as well as demographics, clinical pathological characteristics, and tumor-related parameters to clarify clinical risk factors for HCC EHM. These risks were selected to build an R-based clinical prediction model. The predictive accuracy and discriminating ability of the model were determined by the concordance index (C-index) and the calibration curve. The results were validated with a bootstrap resample and 151 patients from 1 June 2018 to 31 December 2019 at the same facility.
In multivariate analysis, independent factors for EHM were neutrophils, prothrombin time, tumor number, and size, all of which were selected in the model. The C-index in the EHM prediction model was 0.672 and in the validation cohort was 0.694. In the training cohort and the validation cohort, the calibration curve for the probability of EHM showed good agreement between the nomogram prediction and the actual observation.
The extrahepatic metastasis prediction model of hepatocellular carcinoma constructed in this study has some evaluation capability.
本研究旨在探讨肝细胞癌（HCC）伴肝外转移（EHM）患者的临床特征和危险因素，并建立有效的预测列线图。
记录2015年1月1日至2018年5月31日在青海大学附属医院收治的607例肝细胞癌患者的临床和病理数据，以及人口统计学、临床病理特征和肿瘤相关参数，以明确HCC EHM的临床危险因素。选择这些危险因素构建基于R的临床预测模型。通过一致性指数（C指数）和校准曲线确定模型的预测准确性和鉴别能力。结果通过自抽样重采样以及对2018年6月1日至2019年12月31日在同一机构的151例患者进行验证。
在多因素分析中，EHM的独立因素为中性粒细胞、凝血酶原时间、肿瘤数量和大小，所有这些因素均被纳入模型。EHM预测模型的C指数为0.672，验证队列中的C指数为0.694。在训练队列和验证队列中，EHM概率的校准曲线显示列线图预测与实际观察结果之间具有良好的一致性。
本研究构建的肝细胞癌肝外转移预测模型具有一定的评估能力。
