Novel Nomograms Based on Gamma-Glutamyl Transpeptidase-to-Lymphocyte Ratio Predict Prognosis of Hepatocellular Carcinoma Patients After Hepatectomy

被引:5
作者
Ma, Cheng [1 ,4 ]
Cao, Yin [1 ]
Zhang, Guang [1 ,3 ]
Qiu, Jiannan [2 ]
Zhou, Yan [1 ]
Wang, Peng [2 ]
Wang, Shuo [2 ]
Yan, Dongliang [1 ]
Ma, Ding [2 ]
Jiang, Chunping [1 ,3 ]
Wang, Zhongxia [1 ,3 ]
机构
[1] Nanjing Med Univ, Drum Tower Clin Coll, Dept Hepatobiliary Surg, Nanjing, Peoples R China
[2] Nanjing Univ, Affiliated Drum Tower Hosp, Med Sch, Dept Hepatobiliary Surg, Nanjing, Peoples R China
[3] Jinan Microecol Biomed Shandong Lab, Dept Tissue Engn, Jinan, Peoples R China
[4] Xuzhou Cent Hosp, Dept Gastrointestinal Surg, Xuzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
hepatocellular carcinoma; nomogram; gamma-glutamyl transferase; lymphocyte; hepatectomy; MICROVASCULAR INVASION RISK; HEPATITIS-B; LIVER-TRANSPLANTATION; RECURRENCE; CANCER; GUIDELINES; RESECTION; SURVIVAL; AFP; GGT;
D O I
10.2147/JHC.S391755
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The prediction of prognosis of hepatocellular carcinoma (HCC) is of great significance in improving disease outcome and optimizing clinical management, while reliable prognostic indicators are lacking. This study was conducted to develop readily-touse nomograms for prognosis prediction of HCC after hepatectomy.Materials and Methods: Data of eligible patients were collected and analyzed retrospectively. Independent prognostic factors were identified by Cox regression, and nomograms for the prediction of disease-free survival (DFS) and overall survival (OS) were developed. The performance of the nomograms was evaluated by receiver operating characteristics (ROC) curves, C-indexes and calibration curves and was verified by the validation cohort. The predictive value of the nomograms was also compared with the 8th edition of American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) and the Barcelona Clinic Liver CancerResults: In total, 599 patients were enrolled in the analysis: 420 in the training cohort and 179 in the validation cohort. The optimal cut-off value of Gamma-Glutamyl Transpeptidase-to-Lymphocyte Ratio (GLR) was 19.5. GLR contributed significantly to the nomograms with good predictive power. In ROC analyses, the areas under curve (AUCs) of the nomograms for 1-, 3- and 5-year DFS and OS prediction were 0.758, 0.756, 0.734 and 0.810, 0.799, 0.758, respectively. The C-indexes of the DFS nomogram were 0.697 (95% CI 0.665-0.729) in the training cohort and 0.710 (95% CI 0.664-0.756) in the validation cohort. For OS prediction, the C-indexes were 0.741 (95% CI 0.704-0.778) and 0.758 (95% CI 0.705-0.811) in the training and validation cohorts, respectively. The calibration curves demonstrated satisfactory agreement between nomogram predictions and actual observations. The nomograms demonstrated superior predictive performance to the TNM and the BCLC staging systems.Conclusion: Our novel nomograms showed adequate performance in the prediction of HCC prognosis after hepatectomy, which may facilitate the risk stratification and individualized management of HCC patients.
引用
收藏
页码:217 / 230
页数:14
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