HCC portal hypertension imaging score derived from CT predicts re-bleeding and mortality after acute variceal bleeding

被引：3

作者：

Zhao, Mingyuan ^{[1
]}

Zhang, Binyue ^{[2
]}

Shi, Jianqiang ^{[3
]}

Tang, Xiaoxian ^{[3
]}

Li, Hongxia ^{[1
]}

Li, Shengwen ^{[1
]}

Yang, Yunfeng ^{[4
]}

Han, Yi ^{[4
]}

Wang, Rong ^{[4
]}

Xun, Jian ^{[5
]}

Zhang, Kai ^{[6
]}

Wu, Xirun ^{[7
]}

Zhao, Jiang ^{[4
]}

机构：

[1] Shanxi Med Univ, Shanxi Prov Peoples Hosp, Dept Oncol, Taiyuan 030012, Peoples R China

[2] Shanxi Med Univ, Dept Surg, Taiyuan 030001, Peoples R China

[3] Shanxi Med Univ, Shanxi Prov Peoples Hosp, Dept Radiol, Taiyuan 030012, Peoples R China

[4] Shanxi Med Univ, Shanxi Prov Peoples Hosp, Dept Hepatol, 99 Shuang Ta St, Taiyuan 030012, Peoples R China

[5] Shanxi Med Univ, Taiyuan Hosp No 3, Dept Hepatol, Taiyuan 030012, Peoples R China

[6] Shanxi Med Univ, Taiyuan Hosp 3, Dept Radiol, Taiyuan 030012, Peoples R China

[7] Shanxi Med Univ, Hosp 2, Dept Hepatol, Taiyuan 030001, Peoples R China

来源：

CANCER IMAGING | 2024年 / 24卷 / 01期

关键词：

Variceal re-bleeding; Mortality; HCC; Liver cirrhosis; Specificity; HEPATOCELLULAR-CARCINOMA; ESOPHAGEAL-VARICES; RISK;

D O I：

10.1186/s40644-024-00689-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background/Purpose Risk factors for re-bleeding and death after acute variceal bleeding (AVB) in cirrhotic HCC patients are not fully understood.We aimed to (1) explore how the combination of high-risk esophageal varices, HCC status, and portal vein tumor thrombus (i.e., HCC Portal Hypertension Imaging Score [HCCPHTIS]) helps predict increased risk of variceal re-bleeding and mortality; (2) assess predictability and reproducibility of the identified variceal re-bleeding rules. Methods This prospective study included 195 HCC patients with first-time AVB and liver cirrhosis, and conducted multivariable Cox regression analysis and Kaplan-Meier analysis. Receiver operating characteristic curve analysis was calculated to find the optimal sensitivity, specificity, and cutoff values of the variables. The reproducibility of the results obtained was verified in a different but related group of patients. Results 56 patients (28.7%) had re-bleeding within 6 weeks; HCCPHTIS was an independent risk factor for variceal re-bleeding after AVB (Odd ratio, 2.330; 95% confidence interval: 1.728-3.142, p < 0.001). The positive predictive value of HCCPHTIS cut off value > 3 was 66.2%, sensitivity 83.9%, and specificity 82.3%. HCCPHTIS area under the curve was higher than Child-Pugh score (89% vs. 75%, p < 0.001). 74(37.9%) death occurred within 6 weeks; HCCPHTIS > 4 was associated with increased risk of death within 6 weeks after AVB (p < 0.001). Conclusion HCCPHTIS > 3 is a strong predictor of variceal re-bleeding within the first 6 weeks. However, patients with HCCPHTIS > 4 were at increased risk of death within 6 weeks.

引用

页数：10