Wang Yi-Jing, Xu Jian-Xia, Ke Tian-Yu, Li Bao-Na, Zheng Xiao-Zhong, Xiang Jun-Yi, Fan Shu-Feng, Huang Xiao-Shan
Department of Radiology, HangZhou Red Cross Hospital, Hangzhou, China.
Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Front Surg. 2025 Aug 1;12:1488276. doi: 10.3389/fsurg.2025.1488276. eCollection 2025.
Based on MRI features, a scoring model was constructed to predict early recurrence after surgical resection of hepatocellular carcinoma (HCC).
A total of 310 patients from two centers with HCC (212 in the training cohort, 98 in the validation cohort) were collected from January 2017 to October 2023, all patients underwent preoperative MRI-enhanced examinations and were pathologically diagnosed after resection and were divided into early recurrence group and non-early recurrence group based on follow-up results. Clinical, laboratory, and MRI features of patients were collected and subjected to statistical analysis. Univariate analysis and multivariable analysis were used to identify independent predictive factors. The independent predictive factors for early recurrence of liver cancer were weighted using regression coefficient-based scores and construct a score model integrating preoperative variables. Subsequently, receiver operating characteristic (ROC) curves and calibration curves were created to evaluate the performance of the scoring model. The overall score distribution was divided into four groups to show the probability of distinguishing early recurrence.
After multifactor analysis, tumor number, tumor margin, peritumoral enhancement, and macrovascular invasion were identified as independent predictors of early recurrence in preoperative variables. Among them, the tumor margin predictor was assigned 3 points, while the remaining predictors were each assigned 2 points. With a cutoff value of 3.5 points, the ROC value of the score model were 0.873 and 0.847, with sensitivities of 83.9% and 81.3%, and specificities of 77.8% and 73.8%. According to the scores, the predictive ability of early recurrence increased across the four groups.
The established scoring model effectively predicts early recurrence after surgical resection of HCC. The simplicity of the scoring model facilitates clinical application, aiding in the development of personalized treatment plans before surgery.
基于磁共振成像(MRI)特征构建评分模型,以预测肝细胞癌(HCC)手术切除后的早期复发情况。
收集了2017年1月至2023年10月来自两个中心的310例HCC患者(训练队列212例,验证队列98例),所有患者均接受了术前MRI增强检查,术后经病理诊断,并根据随访结果分为早期复发组和非早期复发组。收集患者的临床、实验室和MRI特征并进行统计分析。采用单因素分析和多因素分析确定独立预测因素。利用基于回归系数的评分对肝癌早期复发的独立预测因素进行加权,并构建整合术前变量的评分模型。随后,绘制受试者工作特征(ROC)曲线和校准曲线,以评估评分模型的性能。将总体评分分布分为四组,以显示区分早期复发的概率。
多因素分析后,肿瘤数量、肿瘤边缘、瘤周强化和大血管侵犯被确定为术前变量中早期复发的独立预测因素。其中,肿瘤边缘预测因素赋值3分,其余预测因素各赋值2分。以3.5分为临界值,评分模型的ROC值分别为0.873和0.847,灵敏度分别为83.9%和81.3%,特异度分别为77.8%和73.8%。根据评分,四组中早期复发的预测能力均有所提高。
所建立的评分模型能有效预测HCC手术切除后的早期复发情况。评分模型的简单性便于临床应用,有助于术前制定个性化治疗方案。