Validation of an IGF-CTP scoring system for assessing hepatic reserve in Egyptian patients with hepatocellular carcinoma.
Validation of an IGF-CTP scoring system for assessing hepatic reserve in Egyptian patients with hepatocellular carcinoma.
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DOI：
10.18632/oncotarget.4176
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发表时间：
2015-08-28
期刊：
影响因子：
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通讯作者：
Kaseb AO
中科院分区：
文献类型：
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作者：
Abdel-Wahab R;Shehata S;Hassan MM;Xiao L;Lee JS;Cheung S;Essa HH;Hassabo HM;Shalaby AS;Mosad E;Raghav K;Rashid A;Wolff RA;Morris JS;Amin HM;Kaseb AO
Child-Turcotte-Pugh评分(CTP)是评估肝细胞癌患者肝脏储备的标准工具。最近，我们在两个独立的美国队列中报道，将血浆胰岛素样生长因子-1(IGF-1)水平纳入CTP评分与更好的患者风险分层相关。我们目前的研究旨在验证具有不同人口学特征和危险因素的患者的IGF-CTP评分。我们前瞻性地招募了100名埃及患者，并计算了他们的IGF-CTP评分与CTP评分。C指数用于比较两种评分系统的预后意义。最后，我们将我们的结果与我们的美国队列公布的数据进行了比较。在国际验证队列中，与CTP评分相比，IGF-CTP评分显示明显更好的患者分层。在通常考虑积极治疗和临床试验登记的CTP A类患者中，32.5%的患者被重新分类为IGF-CTP B类患者，与重新分类为A类患者相比，OS显著缩短，危险比[HR]=6.15，95%可信区间[CI]=2.18-17.37。IGF-CTP评分不仅在美国人群中显示出显著更好的患者分层和生存预测，而且在具有不同人口学特征和肝癌危险因素的国际验证人群中也显示出显著更好的患者分层和生存预测。
The Child-Turcotte-Pugh score (CTP) is the standard tool for hepatic reserve assessment in hepatocellular carcinoma (HCC). Recently, we reported that integrating plasma insulin-like growth factor-1 (IGF-1) level into the CTP score was associated with better patient risk stratification in two U.S. independent cohorts. Our current study aimed to validate the IGF-CTP score in patients who have different demographics and risk factors. We prospectively recruited 100 Egyptian patients and calculated their IGF-CTP score compared to CTP score. C-index was used to compare the prognostic significance of the two scoring systems. Finally, we compared our results with our U.S. cohorts published data. IGF-CTP score showed significant better patient stratification compared to CTP score in the international validation cohort. Among CTP class A patients, who usually considered for active treatment and clinical trial enrollment, 32.5% were reclassified as IGF-CTP class B with significantly shorter OS than patients reclassified as class A with hazard ratio [HR] = 6.15, 95% confidence interval [CI] = 2.18-17.37. IGF-CTP score showed significantly better patient stratification and survival prediction not only in the U.S. population but also in international validation population, who had different demographics and HCC risk factors.