Minimally Invasive Intervention Department, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, China.
Sci Rep. 2024 Feb 8;14(1):3303. doi: 10.1038/s41598-024-53711-y.
Post-embolization syndrome (PES) is a frequent complication after receiving transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC), but only a few studies have focused on the factors influencing PES in those patients. In this study, the impact factors of PES were explored and a nomogram was constructed to predict the occurrence of PES in HCC patients with TACE. This was a retrospective cohort study of HCC patients who underwent TACE obtained from the third affiliated Hospital of Kunming Medical University between January 1, 2020, and September 1, 2022. T‑test and Chi‑square test were used to search for factors influencing PES occurrence, and then the nomogram was further established based on multivariable logistic regression analysis. Validation of the predictive nomogram was also evaluated by calibration curve, concordance index (C-index), and receiver operating characteristic (ROC) curves. The enrolled patients (n = 258) were randomly assigned to the primary cohort (n = 180) and validation cohort (n = 78) in a 7:3 ratio. Among 180 patients in the primary cohort, 106 (58.89%) experienced PES. TACE types (P = 0.015), embolization degree (P = 0.008), and tumor number (P = 0.026) were identified as predictors by the logistic regression analysis and were used to develop the predictive nomogram. The internally validated and externally validated C-indexes were 0.713 and 0.703, respectively. The calibration curves presented good consistency between actual and predictive survival. Types of embolic agents, embolization degree, and tumor number were found to be the predictors of PES after TACE. The nomogram could reliably predict PES in HCC patients with TACE. This predictive model might be considered for clinical practice.
经导管动脉化疗栓塞术（TACE）后综合征（PES）是肝细胞癌（HCC）患者接受 TACE 后的常见并发症，但只有少数研究关注影响此类患者 PES 的因素。本研究旨在探讨 HCC 患者 TACE 后 PES 的影响因素，并构建列线图预测 TACE 后 HCC 患者 PES 的发生。这是一项回顾性队列研究，纳入了 2020 年 1 月 1 日至 2022 年 9 月 1 日期间在昆明医科大学第三附属医院接受 TACE 的 HCC 患者。采用 t 检验和卡方检验寻找影响 PES 发生的因素，然后基于多变量逻辑回归分析进一步建立列线图。通过校准曲线、一致性指数（C 指数）和受试者工作特征（ROC）曲线评估预测列线图的验证情况。入组患者（n=258）按 7:3 的比例随机分为主要队列（n=180）和验证队列（n=78）。在主要队列的 180 例患者中，106 例（58.89%）发生 PES。多变量逻辑回归分析显示，TACE 类型（P=0.015）、栓塞程度（P=0.008）和肿瘤数量（P=0.026）是 PES 的预测因素，并用于构建预测列线图。内部验证和外部验证的 C 指数分别为 0.713 和 0.703。校准曲线显示实际生存率与预测生存率之间具有良好的一致性。栓塞剂类型、栓塞程度和肿瘤数量是 TACE 后 PES 的预测因素。该列线图可可靠地预测 HCC 患者 TACE 后 PES 的发生。该预测模型可能有助于临床实践。
