Jiang Yi, Guo Lu, Han Lei, Li Han, Li Changlun, Wen Lianbin, Song Yanqiong, Wang Zhaoyang, Wang Pan, Guo Qulian, Zhao Wenxi, Liu Mengxiang, Chen Jiali, Wu Zhenying, Yan Yushan, Xu Ke, Gu Tao, Wu Xue, He Kun, Su Ke, Han Yunwei
Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
J Cancer Res Clin Oncol. 2023 Nov;149(15):14271-14282. doi: 10.1007/s00432-023-05089-z. Epub 2023 Aug 10.
The aim of this study was to investigate the role of thymidine kinase 1 (TK1) levels in hepatocellular carcinoma (HCC) prognosis and to develop a nomogram for predicting HCC prognosis.
In this study, 1066 HCC patients were enrolled between August 2018 and April 2022. TK1 levels were measured within one week before enrollment, and the relationship with HCC prognosis was evaluated. Next, all patients were randomly assigned to the training set (70%, n = 746) and the validation set (30%, n = 320). We used multivariate Cox analysis to find independent prognostic factors in the training set to construct a nomogram. The predictive power of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The optimal critical value of TK1 was determined as 2.35 U/L using X-tile software.
Before and after propensity score matching (PSM), the median overall survival (mOS) of the low-TK1 group (< 2.35 U/L) remained significantly longer than that of the high-TK1 group (≥ 2.35 U/L) (48.1 vs 16.5 months, p < 0.001; 75.7 vs 19.8 months, p = 0.001). Moreover, multivariate Cox analysis showed that the low TK1 level was an independent positive prognostic indicator. Additionally, the area under the ROC curve for predicting the 1-year, 2-year, and 3-year survival rates was 0.770, 0.758, and 0.805, respectively.
TK1 could serve as a prognostic marker for HCC. In addition, the nomogram showed good predictive capability for HCC prognosis.
本研究旨在探讨胸苷激酶1（TK1）水平在肝细胞癌（HCC）预后中的作用，并开发一种预测HCC预后的列线图。
本研究纳入了2018年8月至2022年4月期间的1066例HCC患者。在入组前一周内测量TK1水平，并评估其与HCC预后的关系。接下来，将所有患者随机分为训练集（70%，n = 746）和验证集（30%，n = 320）。我们使用多因素Cox分析在训练集中寻找独立的预后因素以构建列线图。使用受试者工作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）评估列线图的预测能力。使用X-tile软件确定TK1的最佳临界值为2.35 U/L。
在倾向评分匹配（PSM）前后，低TK1组（<2.35 U/L）的中位总生存期（mOS）显著长于高TK1组（≥2.35 U/L）（48.1个月对16.5个月，p < 0.001；75.7个月对19.8个月，p = 0.001）。此外，多因素Cox分析表明低TK1水平是独立的阳性预后指标。此外，预测1年、2年和3年生存率的ROC曲线下面积分别为0.770、0.758和0.805。
TK1可作为HCC的预后标志物。此外，列线图对HCC预后显示出良好的预测能力。
