Predictive effect of liver fibrosis score and other factors on the prognosis of liver transplantation for liver cancer
10.3760/cma.j.cn421203-20210207-00054
- VernacularTitle:肝纤维化评分等因素对肝癌肝移植预后的预测作用
- Author:
Binhua PAN
1
;
Xuyong WEI
;
Zhikun LIU
;
Li ZHUANG
;
Jianhui LI
;
Mengfan YANG
;
Zhisheng ZHOU
;
Shusen ZHENG
;
Xiao XU
Author Information
1. 浙江大学医学院附属杭州市第一人民医院肝胆胰外科 肿瘤融合研究与精准诊治实验室 310006
- Keywords:
Liver transplantation;
Hepatocellular carcinoma;
Hepatic fibrosis;
Nomogram
- From:
Chinese Journal of Organ Transplantation
2021;42(3):131-135
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of aspartate aminotransferase(AST)and platelet (PLT)ratio index(APRI)in the prognosis of liver transplantation(LT)for hepatocellular carcinoma and establish a nomogram model for evaluating its clinical application potential.Methods:From January 2015 to December 2019, retrospective review was conducted for clinical data of LT for hepatocellular carcinoma(HCC)at First Affiliated Hospital of Zhejiang University School of Medicine and Shulan(Hangzhou)Hospital(601 cases). They were randomized into two groups of modeling (399 cases)and validation(202 cases)and then divided into low and high APRI groups according to the APRI value at Month 1 post-transplantation. The independent risk factors of recurrence and prognosis post-LT were screened in modeling group using univariate and multivariate Cox regression analyses and were further used for constructing a nomogram prediction model. The receiver operating characteristic curve(ROC)and survival curve were utilized for verifying the accuracy of nomogram prediction model.Results:Univariate and multivariate Cox regression analyses revealed that independent risk factors for the prognosis of HCC-LT included cold ischemic time(CIT) >8 h, beyond Hangzhou criteria, surgical bleeding volume >1 000 ml and APRI >1.5. The AUC of HCC-LT recurrence prediction model was 0.734(95%CI: 0.681~0.787)and 0.749(95%CI: 0.671~0.817)in modeling and validation groups; the AUC of HCC-LT mortality prediction model was 0.735(95%CI: 0.679~0.790)and 0.758(95%CI: 0.682~0.834)in modeling and validation groups.Conclusions:APRI>1.5 is an independent risk factor for postoperative recurrence and mortality after HCC-LT. The nomogram prediction model based upon CIT, Hangzhou criteria, intraoperative bleeding volume and APRI can effectively predict the recurrence and overall survival of LT for HCC.
