Wei Xing, Guo Ziwei, Zhang Tingting, Liang Jun
Department of Medical Oncology, Peking University International Hospital, Beijing, People's Republic of China.
Department of Medicine, Double Crane Runchuang Technology (Beijing) Co., Ltd, Beijing, People's Republic of China.
J Hepatocell Carcinoma. 2025 Jan 21;12:107-121. doi: 10.2147/JHC.S505028. eCollection 2025.
The prognosis is extremely troubling in advanced hepatocellular carcinoma (HCC). Prognostic scores have been developed. Yet, the positive predictive values might appear inadequate. This retrospective study aimed to develop a quick and efficient risk score to assess prognosis and clinical response.
A total of 391 hCC patients were enrolled and were divided into training and validation groups between 2015 and 2024. Patients were separated into high-risk and low-risk groups using X-tile software. Using the COX proportional risk model analysis method, we then created a risk score and examined them using Kaplan-Meier, time-dependent receiver operating characteristics (ROC) curve, and nomogram analysis.
In predicting overall survival (OS), free fatty acid/high-density lipoprotein cholesterol (FFHL), tumor size, and BCLC stage were independent prognostic variables. A new risk score was developed just above and used as a prognostic factor (p < 0.001 in the training and validation groups) and had a high time-dependent ROC for progress-free survival (PFS) (area under the curve [AUC] 0.688-0.789 in the training group; AUC 0.592-0.741 in the validation group) and OS (AUC 0.812-0.918 in the training group; AUC 0.692-0.981 in the validation group). In comparison to the best overall response (BOR), the score offered a more accurate evaluation of durable clinical benefit (DCB) (p < 0.001 in the training and validation group; p = 0.061 vs 0.001 in the training and validation group).
A new score based on lipid markers is a useful tool for evaluating prognosis and distinguishing patients with DCB.
晚期肝细胞癌（HCC）的预后极其令人担忧。已经开发了预后评分系统。然而，其阳性预测值可能显得不足。这项回顾性研究旨在开发一种快速有效的风险评分，以评估预后和临床反应。
共纳入391例HCC患者，并在2015年至2024年期间分为训练组和验证组。使用X-tile软件将患者分为高风险和低风险组。然后，我们采用COX比例风险模型分析方法创建了一个风险评分，并使用Kaplan-Meier法、时间依赖性受试者工作特征（ROC）曲线和列线图分析对其进行检验。
在预测总生存期（OS）方面，游离脂肪酸/高密度脂蛋白胆固醇（FFHL）、肿瘤大小和BCLC分期是独立的预后变量。开发了一个新的风险评分，并将其用作预后因素（训练组和验证组中p<0.001），且在无进展生存期（PFS）方面具有较高的时间依赖性ROC（训练组曲线下面积[AUC]为0.688 - 0.789；验证组AUC为0.592 - 0.741）和OS（训练组AUC为0.812 - 0.918；验证组AUC为0.692 - 0.981）。与最佳总体反应（BOR）相比，该评分对持久临床获益（DCB）的评估更准确（训练组和验证组中p<0.001；训练组和验证组中p = 0.061对比0.001）。
基于脂质标志物的新评分是评估预后和区分具有DCB患者的有用工具。
