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Rethinking Liver Fibrosis Staging in Patients with Hepatocellular Carcinoma: New Insights from a Large Two-Center Cohort Study.
| Content Provider | Europe PMC |
|---|---|
| Author | Xu, Wei Li, Bolun Yang, Zhanwei Li, Jingdong Liu, Fei Liu, Yu |
| Copyright Year | 2022 |
| Abstract | BackgroundHepatocellular carcinoma (HCC) is a prevalent and aggressive malignancy closely related to background chronic liver disease. This study aimed to explore predictive factors associated with background liver fibrosis burden in patients with HCC and sought to construct a practical predictive model for clinical use.MethodsThis large two-center retrospective cohort study evaluated data from Chinese medical centers. Uni- and multivariate ordinal logistic regression analyses were performed to identify variables associated with liver fibrosis stages. Predictive models based on variables identified by multivariate analysis were established in the Derivation Cohort and subjected to internal and external validation. Model performance was evaluated for discriminative and calibration abilities.ResultsMultivariate ordinal logistic regression analysis identified liver fibrosis severity score (LFSS), portal hypertension (PH) severity, plateletcrit (PCT) and model for end-stage liver disease-sodium (MELD-Na) as independent predictors of liver fibrosis stage in HCC patients. Nomograms that integrated these factors disclosed that the area under receiver operating characteristic curves (AUROCs) to predict S1 in the Derivation and External Validation cohorts were 0.850 and 0.919, respectively. Internal validation disclosed C-indexes of 0.823 and 0.833 in the Derivation and External Validation cohorts, respectively, indicating that the nomogram had good and excellent performance for distinguishing between S1 and non-S1 patients. Nomogram performance in the Derivation and External Validation cohorts, respectively, was fair and good to predict stage S2 (AUROCs 0.726, 0.806; C-indexes 0.713, 0.791); poor for S3 (AUROCs 0.648, 0.698; C-indexes 0.616, 0.666); good for S4 (AUROCs 0.812, 0.824; C-indexes 0.804, 0.792); and good for S3+S4 (AUROCs 0.806, 0.840; C-indexes 0.795, 0.811).ConclusionWe propose new predictive models for the staging of background liver fibrosis in patients with HCC that can be implemented into clinical practice as important complements to hepatic imaging to inform HCC management strategy. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9380840&blobtype=pdf |
| Page Count | 31 |
| Journal | Journal of Hepatocellular Carcinoma [J Hepatocell Carcinoma] |
| Volume Number | 9 |
| PubMed Central reference number | PMC9380840 |
| PubMed reference number | 35983561 |
| e-ISSN | 22535969 |
| DOI | 10.2147/jhc.s372577 |
| Language | English |
| Publisher | Dove |
| Publisher Date | 2022-08-12 |
| Access Restriction | Open |
| Rights License | This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). © 2022 Xu et al. |
| Subject Keyword | hepatocellular carcinoma liver fibrosis portal hypertension MELD-Na plateletcrit |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Oncology |
