Contrast-enhanced CT findings-based model to predict MVI in patients with hepatocellular carcinoma

BMC Gastroenterology

Research

Xudong Zhang¹  Yang Liu²  Yin Yin²  Jincheng Wang²  Kun Wang²  Xiaoliang Xu²  Qiaoyu Liu²  Zheyu Zhou³  Qi Yue⁴  Yu Zhao⁵ 

[1] Department of Hepato-Biliary-Pancreatic Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, China;Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;Department of General Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Graduate School of Peking Union Medical College, Nanjing, China;Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China;Department of Medical Imaging, School of Medical Imaging, Nanjing Medical University, Jiangning, Nanjing, China;

关键词: Hepatocellular carcinoma;    Microvascular invasion;    Nomogram;    Preoperative prediction;   

DOI  :  10.1186/s12876-022-02586-2

 received in 2022-08-31, accepted in 2022-11-16,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundMicrovascular invasion (MVI) is important in early recurrence and leads to poor overall survival (OS) in hepatocellular carcinoma (HCC). A number of studies have reported independent risk factors for MVI. In this retrospective study, we designed to develop a preoperative model for predicting the presence of MVI in HCC patients to help surgeons in their surgical decision-making and improve patient management.Patients and MethodsWe developed a predictive model based on a nomogram in a training cohort of 225 HCC patients. We analyzed patients’ clinical information, laboratory examinations, and imaging features from contrast-enhanced CT. Mann–Whitney U test and multiple logistic regression analysis were used to confirm independent risk factors and develop the predictive model. Internal and external validation was performed on 75 and 77 HCC patients, respectively. Moreover, the diagnostic performance of our model was evaluated using receiver operating characteristic (ROC) curves.ResultsIn the training cohort, maximum tumor diameter (> 50 mm), tumor margin, direct bilirubin (> 2.7 µmol/L), and AFP (> 360.7 ng/mL) were confirmed as independent risk factors for MVI. In the internal and external validation cohort, the developed nomogram model demonstrated good diagnostic ability for MVI with an area under the curve (AUC) of 0.723 and 0.829, respectively.ConclusionBased on routine clinical examinations, which may be helpful for clinical decision-making, we have developed a nomogram model that can successfully assess the risk of MVI in HCC patients preoperatively. When predicting HCC patients with a high risk of MVI, the surgeons may perform an anatomical or wide-margin hepatectomy on the patient.

【 授权许可】

CC BY   
© The Author(s) 2022

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