Development and evaluation of a nomogram prediction model for invasion and metastasis in primary liver cancer based on serum CD147 and IL-6.

OBJECTIVE

This study aims to develop a prediction model for invasive metastasis of primary liver cancer based on serum extracellular matrix metalloproteinase-inducing factor (CD147) and interleukin-6 (IL-6).

METHODS

Between July 2022 and August 2024, 170 surgically treated primary hepatocellular carcinoma patients at our hospital were recruited. They were divided into a training group ( = 120) and a validation group ( = 50) at a 7:3 ratio. Univariate and multivariate logistic regression analyses were applied in the training group to identify factors related to invasive metastasis. A risk factor-based bar chart prediction model was then constructed and internally tested. Its goodness of fit was evaluated, and the model's diagnostic efficacy was assessed using the ROC curve. Finally, decision curve analysis (DCA) was performed to evaluate the model's clinical value.

RESULTS

In the training group, compared with the noninvasive metastasis group, patients in the invasive metastasis group had a significantly lower percentage of intact envelope and tumor size ≥5 cm, and significantly higher serum alpha-fetoprotein (AFP), alkaline phosphatase (ALP), C-reactive protein/albumin ratio (CAR), oncoglobulin (CEA), CD147, and IL-6 levels (all < 0.05). After logistic multifactorial analysis, intact envelope, tumor > 5 cm, AFP, CAR, CD147, and IL-6 were identified as independent influencing factors for invasive metastasis of primary hepatocellular carcinoma (all < 0.05). A column chart model was constructed. The C-index of the training and validation groups was 0.884 (95% confidence interval [CI]: 0.738-0.932) and 0.841 (95% CI: 0.741-0.939), respectively. The calibration curves showed good agreement between the predicted probability and the actual probability in both the training and validation groups, without significant deviation. The area under the curve (AUC) of the ROC analysis was 0.852 (95% CI: 0.824-0.979) and 0.839 (95% CI: 0.791-0.912), respectively. DCA indicated that the model had clinical application value within a certain range of threshold probabilities.

CONCLUSION

The prediction model based on serum CD147, IL-6, and other risk factors for the invasion and metastasis of primary hepatocellular carcinoma demonstrates high diagnostic value.