Establishment and validation of a predictive model for HBV-positive hepatocellular carcinoma
10.3760/cma.j.cn114452-20210719-00442
- VernacularTitle:乙型肝炎病毒阳性肝硬化患者进展为肝细胞肝癌预测模型的建立及验证
- Author:
Kexin ZHAO
1
;
Guangwen XU
;
Nan LI
;
Yongjun JIANG
;
Yonghui FENG
Author Information
1. 中国医科大学附属第一医院临床免疫学教研室，沈阳110001
- Keywords:
Hepatitis B virus;
Liver cirrhosis;
Carcinoma, hepatocellular;
Predictive model
- From:
Chinese Journal of Laboratory Medicine
2022;45(5):516-521
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The risk factors for hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive cirrhosis patients were screened based on commonly used laboratory indexes for the purpose of establishing a predictive model and the prediction efficacy of established model was validated in a validation patient cohort.Methods:The clinical data of 661 male patients with HBV-positive cirrhosis (cirrhosis group) and 694 male patients with HBV-positive HCC admitted to the First Hospital of China Medical University from 2010 to 2020 were retrospectively analyzed, age and complete blood count,liver function index (aspartate transaminase/alanine transaminase,glutamine transpeptidase,total protein, prealbumin, total bile acid, total bilirubin,direct bilirubin,cholinesterase), HBV markers, alpha-fetoprotein (AFP), fibrinogen,calcium were compared between the two groups. Multivariate Logistic regression was used to analyze the independent risk factors of HCC. The prediction model of high risk HCC ( P<0.05) was constructed and validated by receiver operating characteristic (ROC) curve and calibration curve. Results:There was significant difference in complete blood count, liver function index, HBV core antibody, HBV core antibody IgM, alpha-fetoprotein, fibrinogen, calcium between the two groups ( P<0.05). Multivariate analysis showed that calcium ( OR=35.770,95% CI 13.39-99.304),HBV core antibody ( OR=0.878,95% CI 0.816-0.944), AFP ( OR=1.002, 95% CI 1.001-1.003), fibrinogen ( OR=1.369, 95% CI 1.202-1.564) were the independent risk factors for HCC ( P<0.05), and were used for the nomogram. The AUC of the nomogram was 0.750 (95% CI 0.720-0.781) and the AUC of the validation group was 0.752 (95% CI 0.705-0.798). Conclusions:Based on calcium, hepatitis B virus core antibody, AFP, fibrinogen, a nomogram of the HCC is established and verified by ROC curve, which could be used to predict the risk of HBV-positive HCC.
