[1]陆一峰,王 祁,何忠明.构建基于控制营养状况评分的列线图预测肝细胞癌TACE治疗患者预后[J].介入放射学杂志,2023,32(12):1190-1196.
 LU Yifeng,WANG Qi,HE Zhongming..Construction of a nomogram based on controlling nutritional status score for predicting the prognosis of hepatocellular carcinoma patients after receiving TACE[J].journal interventional radiology,2023,32(12):1190-1196.
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构建基于控制营养状况评分的列线图预测肝细胞癌TACE治疗患者预后()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年12
页码:
1190-1196
栏目:
肿瘤介入
出版日期:
2024-01-02

文章信息/Info

Title:
Construction of a nomogram based on controlling nutritional status score for predicting the prognosis of hepatocellular carcinoma patients after receiving TACE
作者:
陆一峰 王 祁 何忠明
Author(s):
LU Yifeng WANG Qi HE Zhongming.
Department of Interventional Radiology, Third Affiliated Hospital of Soochow University (Changzhou Municipal First People’s Hospital), Changzhou, Jiangsu Province 213000, China
关键词:
【关键词】 肝细胞癌 经导管动脉化疗栓塞术 控制营养状况评分 列线图 预后预测
文献标志码:
A
摘要:
【摘要】 目的 探讨控制营养状况(CONUT)评分对经导管动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)患者的预后意义,并构建整合多种预后因素的列线图模型,以帮助临床医师准确预测个体预后。方法 回顾性分析2017年1月至2020年6月于苏州大学附属第三医院接受TACE治疗的155例原发性HCC患者临床资料。通过受试者工作特征曲线(ROC)分析CONUT评分最佳截断值,Kaplan-Meier曲线分析其预后意义。采用单变量、多变量Cox生存分析确定接受TACE治疗HCC患者独立预后因素。以多变量分析的显著变量构建列线图模型,使用一致性指数(C-index)评价其预测TACE治疗HCC患者总生存期(OS)能力。绘制校准曲线评价预测概率与实际OS结局间的一致性。结果 CONUT评分预测OS最佳截断值为4,AUC值为0.766(95%CI=0.691~0.841)。高CONUT评分(≥4)组患者肿瘤直径更大(P=0.014),血清AFP水平更高(P=0.002),肝储备功能(P<0.01)和TACE治疗反应(P<0.01)更差,中位OS更短(P<0.01)。Child-Pugh分级、肿瘤最大直径、血清AFP水平、BCLC分期、TACE治疗反应及CONUT评分(均P<0.05)是TACE治疗后HCC患者OS的独立预测因素。基于以上变量构建列线图模型,其C-index为0.785(95%CI=0.691~0.879)。校准曲线显示模型预测概率与实际概率间具有高度一致性。结论 CONUT评分是评价接受TACE治疗HCC患者预后的简单可行工具。基于肿瘤生物学特征、TACE治疗反应及CONUT评分的列线图模型对HCC患者具有可靠的预后预测能力,值得进一步推广验证。

参考文献/References:

[1] Heimbach JK, Kulik LM, Finn RS, et al. AASLD guidelines for the treatment of hepatocellular carcinoma[J]. Hepatology, 2018, 67: 358- 380.
[2] 中华人民共和国国家卫生健康委员会.原发性肝癌诊疗指南(2022年版)[J]. 传染病信息, 2022, 35:1- 26.
[3] Ebeling Barbier C, Heindryckx F, Lennernas H. Limitations and possibilities of transarterial chemotherapeutic treatment of hepatocellular carcinoma[J]. Int J Mol Sci, 2021, 22: 13051.
[4] Zhong BY, Jin ZC, Chen JJ, et al. Role of transarterial chemoembolization in the treatment of hepatocellular carcinoma[J]. J Clin Transl Hepatol, 2023, 11: 480- 489.
[5] Gillmore R, Stuart S, Kirkwood A, et al. EASL and mRECIST responses are independent prognostic factors for survival in hepatocellular cancer patients treated with transarterial embolization[J]. J Hepatol, 2011, 55: 1309- 1316.
[6] Waked I, Berhane S, Toyoda H, et al. Transarterial chemo- embolisation of hepatocellular carcinoma: impact of liver function and vascular invasion[J]. Br J Cancer, 2017, 116: 448- 454.
[7] Tian M, Zhang X, Huang G, et al. Alpha- fetoprotein assessment for hepatocellular carcinoma after transarterial chemoembolization[J]. Abdom Radiol(NY), 2019, 44: 3304- 3311.
[8] Ji K, Zhu H, Wu W, et al. Tumor response and nomogram- based prognostic stratification for hepatocellular carcinoma after drug- eluting beads transarterial chemoembolization[J]. J Hepatocell Carcinoma, 2022, 9: 537- 551.
[9] Müller L, Hahn F, Mahringer- Kunz A, et al. Immunonutritive scoring in patients with hepatocellular carcinoma undergoing transarterial chemoembolization: prognostic nutritional index or controlling nutritional status score?[J]. Front Oncol, 2021, 11: 696183.
[10] Roth G, Teyssier Y, Benhamou M, et al. Impact of sarcopenia on tumor response and survival outcomes in patients with hepatocellular carcinoma treated by trans- arterial(chemo)- embolization[J]. World J Gastroenterol, 2022, 28: 5324- 5337.
[11] Lin ZX, Ruan DY, Jia CC, et al. Controlling nutritional status (CONUT) score- based nomogram to predict overall survival of patients with HBV- associated hepatocellular carcinoma after curative hepatectomy[J]. Clin Transl Oncol, 2020, 22: 370- 380.
[12] Peng W, Yao M, Zou K, et al. Postoperative controlling nutritional status score is an independent risk factor of survival for patients with small hepatocellular carcinoma: a retrospective study[J]. BMC Surg, 2021, 21: 338.
[13] Tsunematsu M,Haruki K, Fujiwara Y, et al. Preoperative controlling nutritional status (CONUT) score predicts long- term outcomes in patients with non- B non- C hepatocellular carcinoma after curative hepatic resection[J]. Langenbecks Arch Surg, 2021, 406: 99- 107.
[14] Ignacio de Ulibarri J, Gonzalez- Madrono A, de Villar NGP, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population[J]. Nutr Hosp, 2005, 20: 38- 45.
[15] 中国医师协会介入医师分会临床诊疗指南专委会.中国肝细胞癌经动脉化疗栓塞(TACE)治疗临床实践指南(2021年版)[J].中华医学杂志,2021,101:1848- 1862.
[16] Llovet JM, Lencioni R. mRECIST for HCC: performance and novel refinements[J]. J Hepatol, 2020, 72: 288- 306.
[17] Ho SY, Hsu CY, Liu PH, et al. Albumin- bilirubin (ALBI) grade- based nomogram for patients with hepatocellular carcinoma undergoing transarterial chemoembolization[J]. Dig Dis Sci, 2021, 66: 1730- 1738.
[18] 张司马康,周春高,施海彬,等.骨骼肌质量指数对TACE治疗肝癌的预测价值[J]. 介入放射学杂志, 2022, 31:1170- 1173.
[19] Zhang YQ, Jiang LJ, Wen J, et al. Comparison of α- fetoprotein criteria and modified response evaluation criteria in solid tumors for the prediction of overall survival of patients with hepatocellular carcinoma after transarterial chemoembolization[J]. J Vasc Interv Radiol , 2018, 29: 1654- 1661.
[20] Cun J, Xu Y, Li W, et al. Analysis of factors affecting the prognosis of transcatheter arterial chemoembolization for hepatitis B- related hepatocellular carcinoma[J]. J Interv Med, 2021, 4: 66- 70.
[21] Chon YE, Park H, Hyun HK, et al. Development of a new nomogram including neutrophil- to- lymphocyte ratio to predict survival in patients with hepatocellular carcinoma undergoing transarterial chemoembolization[J]. Cancers(Basel), 2019, 11:509.
[22] Li J, Li C, Zhu G, et al. A novel nomogram to predict survival of patients with hepatocellular carcinoma after transarterial chemoembolization: a tool for retreatment decision making[J]. Ann Transl Med, 2023, 11: 68.
[23] Shimose S, Kawaguchi T, Iwamoto H, et al. Controlling nutritional status(CONUT) score is associated with overall survival in patients with unresectable hepatocellular carcinoma treated with lenvatinib: a multicenter cohort study[J]. Nutrients,2020,12:1076.
[24] Tamai Y, Iwasa M, Eguchi A, et al. The prognostic role of controlling nutritional status and skeletal muscle mass in patients with hepatocellular carcinoma after curative treatment[J]. Eur J Gastroenterol Hepatol, 2022,34: 1269- 1276.
[25] European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2018, 69: 182- 236.
[26] Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American association for the study of liver diseases[J]. Hepatology, 2018, 68: 723- 750.
[27] Prajapati HJ, Spivey JR, Hanish SI, et al. mRECIST and EASL responses at early time point by contrast- enhanced dynamic MRI predict survival in patients with unresectable hepatocellular carcinoma(HCC) treated by doxorubicin drug- eluting beads transarterial chemoembolization(DEB TACE)[J]. Ann Oncol, 2013, 24: 965- 973.
[28] Jung J, Joo JH, Kim SY, et al. Radiologic response as a prognostic factor in advanced hepatocellular carcinoma with macroscopic vascular invasion after transarterial chemoembolization and radiotherapy[J]. Liver Cancer, 2022, 11: 152- 161.

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备注/Memo

备注/Memo:
(收稿日期:2023- 04- 14)
(本文编辑:谷 珂)
更新日期/Last Update: 2024-01-02