摘要
目的:建立一个预测肝细胞癌发生微血管侵犯的诊断模型。方法:研究2018年5月至2020年4月广西医科大学第一附属医院肝胆外科收治的156例符合纳入和排除标准的肝癌患者作为模型组。建立术前中性粒细胞-淋巴细胞比(NLR)、血清甲胎蛋白联合异常凝血酶原对肝细胞癌MVI预测的诊断模型。结果:建立NLR、血清甲胎蛋白联合异常凝血酶原对MVI的预测诊断模型;通过ROC曲线分析得出结果,曲线下面积(AUC)为0.781[95%可信区间(CI):0.707~0.855],敏感度为75.8%,特异度为73.3%,Youden指数为0.491;再通过Hosmer-Lemeshow拟合优度检验对已建立的预测MVI的诊断模型进行校准度分析,得到结果为,χ^(2)=5.740,P=0.570。P>0.05。通过已建立的Logistic回归模型的对验证组数据进行验证,得到的阳性预测值为75.0%,阴性预测值为88.9%,预测的准确率为83.7%;ROC曲线分析结果显示,该模型鉴别MVI的AUC为0.903,95%CI为0.815~0.992。结论:NLR、血清甲胎蛋白联合异常凝血酶原对肝细胞癌合并MVI的预测诊断模型可有效预测MVI的发生。
Objective To establish a diagnostic model for predicting microvascular invasion in hepatocellular carcinoma.Methods A total of 156 patients with liver cancer who met the inclusion and exclusion criteria and were admitted to the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Guangxi Medical University from May 2018 to April 2020 were enrolled as the model group.To establish a diagnostic model of preoperative neutrophil to lymphocyte ratio(NLR),serum alpha-fetoprotein combined with abnormal prothrombin for the prediction of MVI in hepatocellular carcinoma.Results A predictive diagnostic model of MVI was established for neutrophil-lymphocyte ratio,serum alpha-fetoprotein combined with abnormal prothrombin.The area under curve(AUC)was 0.781[95%confidence interval(CI):0.707-0.855],the sensitivity was 75.8%,the specificity was 73.3%,and the Youden index was 0.491.Then,the calibration degree of the established diagnostic model for predicting MVI was analyzed by Hosmer-Lemeshow goodness-of-fit test,and the result wasχ^(2)=5.740,P>0.05).The established Logistic regression model was used to verify the validation group data.The positive predictive value was 75.0%,the negative predictive value was 88.9%,and the prediction accuracy was 83.7%.ROC curve analysis showed that the AUC of this model for identifying MVI was 0.903,95%CI was 0.815-0.992.Conclusion Neutrophil-lymphocyte ratio,serum alpha-fetoprotein combined with abnormal prothrombin can effectively predict the occurrence of MVI in hepatocellular carcinoma.
作者
蒋传林
田森
朱福
吕军
Jiang Chuanlin;Tian Sen;Zhu Fu;Lyu Jun(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《中华实验外科杂志》
CAS
北大核心
2022年第12期2440-2442,共3页
Chinese Journal of Experimental Surgery
基金
广西南宁市青秀区科技攻关计划(2020050)
广西医药卫生适宜技术开发推广应用项目(S2021097)
广西重点研发计划(2021AB11126)。
关键词
肝细胞癌
微血管侵犯
中性粒细胞-淋巴细胞
血清甲胎蛋白
异常凝血酶原
Hepatocellular carcinoma
Microvascular invasion
Neutrophil-lymphocytes
Serum alpha-fetoprotein
Des-γ-carboxy-prothrombin
