肝细胞癌高危人群评分量表的构建及独立预测因素评估

Construction of a hepatocellular carcinoma high-risk population rating scale and independent predictors' assessment.

作者信息

Li Manyu, Sun Jing, Wang Yan, Ma Jun, Hao Xiaotian, Liu Yan, Zhou Cheng, Zhou Haiwei

机构信息

Division I of In Vitro Diagnostics for Infectious Diseases, Institute for In Vitro Diagnostics Control, National Institutes for Food and Drug Control, Beijing, China.

Department of Physiology, Collaborative Innovation Center for Aging Mechanism Research and Transformation, Center for Healthy Aging, Changzhi Medical College, Changzhi, China.

出版信息

Am J Med Sci. 2024 Mar;367(3):181-189. doi: 10.1016/j.amjms.2023.11.016. Epub 2023 Nov 19.

DOI:10.1016/j.amjms.2023.11.016

PMID:37989441

Abstract

BACKGROUND

With increasing mortality and incidence, hepatocellular carcinoma (HCC) has become a major public health problem. The early diagnosis of HCC can improve its prognosis. The aim of this study was to identify potential risk factors related to HCC development and to establish a high-risk population rating scale.

METHODS

A total of 853 patients with chronic hepatitis B (CHB) were enrolled in this study, including 403 patients with HCC as the case group and others as the control group. Their demographic and clinical characteristics were compared and the independent risk factors for HCC were assessed. Then, the optimal cutoff levels of these factors were analyzed by the receiver operating characteristic (ROC) method. A high-risk population rating scale was constructed based on the factors and then evaluated in the modeling population.

RESULTS

The factors that presented statistically significant differences between the two groups included age, smoking, alcohol abuse, body mass index, triglyceride, high‒density lipoprotein cholesterol, aspartate transaminase, alanine transaminase, fasting plasma glucose, creatinine and uric acid. The ROC curve showed that the cutoff score for the HCC high risk population was 5 (AUC=0.74, P<0.001) and the Hosmer‒Lemeshow analysis showed that the fitting effect of this rating scale was good (P = 0.294).

CONCLUSIONS

The integration of these factors can contribute to a prognostic score for the risk of HCC development, which offered certain clinical practicability.

摘要

背景

随着死亡率和发病率的上升，肝细胞癌（HCC）已成为一个主要的公共卫生问题。HCC的早期诊断可改善其预后。本研究的目的是确定与HCC发生相关的潜在风险因素，并建立一个高危人群评分量表。

方法

本研究共纳入853例慢性乙型肝炎（CHB）患者，其中403例HCC患者作为病例组，其余作为对照组。比较两组患者的人口统计学和临床特征，并评估HCC的独立危险因素。然后，采用受试者工作特征（ROC）方法分析这些因素的最佳截断水平。基于这些因素构建高危人群评分量表，然后在建模人群中进行评估。

结果

两组间具有统计学显著差异的因素包括年龄、吸烟、酗酒、体重指数、甘油三酯、高密度脂蛋白胆固醇、天冬氨酸转氨酶、丙氨酸转氨酶、空腹血糖、肌酐和尿酸。ROC曲线显示，HCC高危人群的截断分数为5（AUC=0.74，P<0.001），Hosmer-Lemeshow分析显示该评分量表的拟合效果良好（P=0.294）。