Development of a nomogram model to predict the postoperative prognosis of patients with hepatocellular carcinoma undergoing hepatectomy
10.3760/cma.j.cn113884-20241111-00329
- VernacularTitle:肝切除术后肝细胞癌患者预后列线图的构建
- Author:
Lu LU
1
;
Chunlong WU
;
Huifei ZHANG
;
Yufen ZHENG
Author Information
1. 浙江省台州医院放射科，临海 317000
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Prognosis;
Nomogram;
Neutrophil to lymphocyte ratio;
Gamma-glutamyl transpeptidase to platelet ratio
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(10):737-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a nomogram model based on the preoperative neutrophil-to-lymphocyte ratio and gamma-glutamyl transpeptidase (GGT) -to-platelet ratio (NLR-GPR) score to predict the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods:Clinical data of 284 patients with HCC who underwent curative resection at Taizhou Hospital of Zhejiang Province between January 2012 and September 2016 were retrospectively analyzed, including 235 males and 49 females, aged 57(51, 65) years. Clinical data, including gender, age, neutrophil count, lymphocyte count, platelet count, GGT, and total bilirubin, were collected. The Cox proportional hazards regression model was employed to assess the relationship between the preoperative NLR-GPR score and patient disease-free survival (DFS) and overall survival (OS). A nomogram was constructed based on the results of the multivariate analysis. Survival curves were generated using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. The performance of the model was assessed by the concordance index (C-index).Results:The NLR-GPR score was found to be negatively correlated with both DFS and OS (both P<0.05), where a higher score indicated a poorer prognosis. Multivariate analysis identified the NLR-GPR score as an independent risk factor for both DFS ( HR=1.463, 95% CI: 1.135-1.887, P=0.003) and OS ( HR=1.734, 95% CI: 1.300-2.313, P<0.001). A nomogram was deve-loped based on the variables selected from the multivariate Cox regression analysis, including postoperative pleural effusion, AJCC stage, vascular invasion, and the NLR-GPR score. This nomogram demonstrated good predictive accuracy, with C-indices for DFS and OS of 0.676 and 0.726, respectively. Conclusion:The nomogram model, constructed based on the preoperative NLR-GPR score and relevant clinicopathological factors, can effectively predict the postoperative survival of patients with HCC undergoing hepatectomy.
