基于ICG-R15的肝细胞型肝癌肝切除术后肝衰竭的列线图临床预测模型

ICG-R15-based clinical prediction model of liver failure after hepatectomy for hepatocellular carcinoma

目的基于ICG-R15建立肝细胞性肝癌(HCC)肝切除术后肝衰竭(PHLF)的列线图(Nomogram)临床预测模型。方法回顾性分析根治性肝切除术的219例肝细胞肝癌患者的临床资料,Logistics回归筛选出PHLF发生的危险因素并建立预测PHLF发生的Nomogram模型,并与传统模型比较,检验其预测效能。结果在本研究中,ICG-R15(OR=1.07,P<0.05)、PLT(OR=0.99,P<0.05)、INR(OR=1.50,P<0.05)、HBV-DNA>1000IU(OR=2.26,P<0.05)、AFP>400ng/L(OR=2.60,P<0.05)、开放手术(OR=0.26,P<0.05)为PHLF发生的危险因素。以这些因子建立了Nomogram预测模型,并通过ROC与DCA分析发现该模型预测效能及临床价值较传统模型更佳。结论成功基于ICG-R15建立肝细胞性肝癌PHLF的Nomogram临床预测模型。

Objective To establish a Nomogram clinical predictive model of liver failure(PHLF)after hepatectomy for hepatocellular carcinoma(HCC)based on ICG-R15.Methods Clinical data of 219 patients with hepatocellular carcinoma who underwent radical hepatectomy in the second affiliated Hospital of Anhui Medical University from February 2017 to March 2022 were analyzed retrospectively.The influencing factors of PHLF were screened by Logistics regression and the Nomogram model for predicting the occurrence of PHLF was established.Compared with the traditional model,its predictive efficiency was tested.Results In this study,ICG-R15(OR=1.07,P<0.05),PLT(OR=0.99,P<0.05),INR(OR=1.50,P<0.05),HBV-DNA>1000IU(OR=2.26,P<0.05),AFP>400ng/L(OR=2.60,P<0.05)and open surgery(OR=0.26,P<0.05)were the influencing factors of PHLF.A Nomogram prediction model was established based on these factors,and through ROC and DCA analysis,it was found that the prediction efficiency and clinical value of this model were better than those of the traditional model.Conclusion The Nomogram clinical predictive model of hepatocellular carcinoma(HCC)PHLF is successfully established based on ICG-R15.