Research Center for Biomedical Resources, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Front Immunol. 2022 Nov 23;13:1019638. doi: 10.3389/fimmu.2022.1019638. eCollection 2022.
PURPOSE: To investigate the risk factors for recurrence in patients with early-stage hepatocellular carcinoma (HCC) after minimally invasive treatment with curative intent, then to construct a prediction model based on Lasso-Cox regression and visualize the model built. METHODS: Clinical data were collected from 547 patients that received minimally invasive treatment in our hospital from January 1, 2012, to December 31, 2016. Lasso regression was used to screen risk factors for recurrence. Then we established Cox proportional hazard regression model and random survival forest model including several parameters screened by Lasso regression. An optimal model was selected by comparing the values of C-index, then the model was visualized and the nomogram was finally plotted. RESULTS: The variables screened by Lasso regression including age, gender, cirrhosis, tumor number, tumor size, platelet-albumin-bilirubin index (PALBI), and viral load were incorporated in the Cox model and random survival forest model (P<0.05). The C-index of these two models in the training sets was 0.729 and 0.708, and was 0.726 and 0.700 in the validation sets, respectively. So we finally chose Lasso-Cox regression model, and the calibration curve in the validation set performed well, indicating that the model built has a better predictive ability. And then a nomogram was plotted based on the model chosen to visualize the results. CONCLUSIONS: The present study established a nomogram for predicting recurrence in patients with early-stage HCC based on the Lasso-Cox regression model. This nomogram was of some guiding significance for screening populations at high risk of recurrence after treatment, by which doctors can formulate individualized follow-up strategies or treatment protocols according to the predicted risk of relapse for patients to improve the long-term prognosis.
目的:研究以根治性微创治疗为手段的早期肝细胞癌(HCC)患者复发的风险因素,然后基于 Lasso-Cox 回归构建预测模型并可视化模型。
方法:收集 2012 年 1 月 1 日至 2016 年 12 月 31 日在我院接受微创治疗的 547 例患者的临床资料。采用 Lasso 回归筛选复发的风险因素。然后建立 Cox 比例风险回归模型和随机生存森林模型,包括 Lasso 回归筛选的几个参数。通过比较 C 指数值选择最优模型,然后对模型进行可视化并最终绘制诺模图。
结果:Lasso 回归筛选出的变量包括年龄、性别、肝硬化、肿瘤数量、肿瘤大小、血小板-白蛋白-胆红素指数(PALBI)和病毒载量,这些变量被纳入 Cox 模型和随机生存森林模型(P<0.05)。两个模型在训练集的 C 指数分别为 0.729 和 0.708,验证集的 C 指数分别为 0.726 和 0.700。因此,我们最终选择了 Lasso-Cox 回归模型,验证集的校准曲线表现良好,表明构建的模型具有更好的预测能力。然后根据所选模型绘制了一个诺模图,以可视化结果。
结论:本研究基于 Lasso-Cox 回归模型建立了早期 HCC 患者复发预测的诺模图。该诺模图对筛选治疗后复发高风险人群具有一定的指导意义,医生可以根据患者复发的预测风险制定个体化的随访策略或治疗方案,从而改善患者的长期预后。
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