Spleen to non-cancerous liver volume ratio predicts liver cirrhosis in hepatocellular carcinoma patients
Spleen to non-cancerous liver volume ratio predicts liver cirrhosis in hepatocellular carcinoma patients
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DOI：
10.1007/s00261-022-03727-7
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发表时间：
2022-11
影响因子：
2.4
通讯作者：
Yan Geng;Wei-qing Shao;Jing Lin
中科院分区：
文献类型：
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作者：
Yan Geng;Wei-qing Shao;Jing Lin
目的探讨脾与非癌肝体积比（STnLR）在肝细胞癌（HCC）患者术前评估中诊断肝硬化的价值。根据Scheuer分期将患者分为肝硬化组和非肝硬化组。使用三维系统重建患者的常规图像数据。计算STnLR、脾与肝体积比（STLR）、脾体积、天冬氨酸转氨酶与血小板比率指数（APRI）和基于四个因素的纤维化指数（FIB-4）。用斯皮尔曼相关分析测定指标与肝硬化的相关性。使用受试者工作特征分析评估和比较诊断性能。验证组对模型的准确性进行分析。结果两组人口学和临床特征无统计学差异。实验组STnLR的相关性最强STLR与脾体积、APRI、FIB-4呈中度相关（r= 0.5399，P < 0.0001）（r= 0.4583，0.4123，0.3648和0.3405，P < 0.0001，<0.0001，= 0.0002）。STnLR的AUROC（0.8326）不高于脾脏体积（0.7542，P = 0.09832）和STLR（0.8046，P = 0.3034），但明显高于APRI（0.7099，P = 0.02046）和FIB-4（0.7294，P = 0.03987）。在验证组中，STnLR的AUROC值最高（0.8538），Youden指数最高（0.5869）。结论STnLR是一种准确、稳定的体积模型，用于HCC人群肝硬化的诊断上级APRI和FIB-4。
PurposeTo investigate the performance of spleen to non-cancerous liver volume ratio (STnLR) for diagnosing liver cirrhosis in patients with hepatocellular carcinoma (HCC) during preoperative evaluation.MethodsPatients were randomly divided into experiment group and validation group. Patients were grouped into cirrhosis group and non-cirrhosis group according to Scheuer staging. Patients’ routine image data were reconstructed using a three-dimensional system. STnLR, spleen to liver volume ratio (STLR), spleen volume, aspartate aminotransferase to platelet ratio index (APRI), and fibrosis index based on the four factors (FIB-4) were calculated. Correlations between indices and cirrhosis were measured by Spearman correlation analysis. Diagnostic performance was assessed and compared using receiver operating characteristic analysis. Accuracies of the models were analyzed in validation group.ResultsNo statistical difference in demographic and clinical characteristics was observed between groups. In experiment group, STnLR had the strongest correlation (r= 0.5399,P< 0.0001), and STLR, spleen volume, APRI, and FIB-4 had moderate correlations (r= 0.4583, 0.4123, 0.3648, and 0.3405,P< 0.0001, < 0.0001, < 0.0001, and = 0.0002) with liver cirrhosis stage. AUROC of STnLR (0.8326) was not statistically higher than that for spleen volume (0.7542,P= 0.09832) and STLR (0.8046,P= 0.3034), but was significantly higher than that for APRI (0.7099,P= 0.02046) and FIB-4 (0.7294,P= 0.03987). In validation group, STnLR showed the highest AUROC value (0.8538) and highest Youden index (0.5869) among all models.ConclusionSTnLR is an accurate and stable volumetric model to diagnose hepatic cirrhosis in the HCC population, which is superior to APRI and FIB-4.Graphical Abstract