A New Scoring Method for Personalized Prognostic Prediction in Patients with Combined Hepatocellular and Cholangiocarcinoma After Surgery
A New Scoring Method for Personalized Prognostic Prediction in Patients with Combined Hepatocellular and Cholangiocarcinoma After Surgery
复制标题
肝细胞癌和胆管癌术后患者个性化预后预测的新评分方法。
DOI：
10.1007/s11605-020-04618-2
复制
发表时间：
2020-04-29
影响因子：
3.2
通讯作者：
Yin, Xin
中科院分区：
文献类型：
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作者：
Zhang, Feng;Hu, Keshu;Yin, Xin
背景与目的肝细胞胆管合并癌（cHCC-CCA）是一种罕见但侵袭性的原发性肝癌，预后较差。我们的目标是开发一种新的评分方法，用于手术切除的cHCC-CCA患者的个性化预后预测。方法回顾性分析中山医院肝癌研究所1993年1月至2015年12月行手术切除的Allen型C型cHCC-CCA患者296例。建立并验证了一种新的cHCC-CCA预后评分方法（PSM-CHCC模型）。新模型的预测值与目前的预后分期系统进行了比较。结果基于Cox回归模型确定的独立预后变量建立评分模型。基于PSM-CHCC模型，根据患者的个体评分将患者分为三个预后亚组：A（评分0-2），B（评分3-5）和C（评分bb50）。在训练和验证队列中，PSM-CHCC模型的预测性能优于广泛接受的TNM分期系统和其他分期系统。亚组分析也验证了PSM-CHCC模型的鉴别效果。结论新建立的PSM-CHCC模型有助于cHCC-CCA患者的预后分层和临床决策。
Background and Aim Combined hepatocellular and cholangiocarcinoma (cHCC-CCA) is a rare but aggressive primary liver cancer with dismal prognosis. We aim to develop a new scoring method for personalized prognostic prediction in patients with cHCC-CCA undergoing surgical resection. Methods Between January 1993 and December 2015, a total of 296 Allen type C cHCC-CCA patients who had received surgical resection in Liver Cancer Institute, Zhongshan Hospital were retrospectively enrolled. A novel prognostic scoring method for cHCC-CCA (PSM-CHCC model) was established and validated. The predictive value of the new model was compared with current prognostic staging systems. Results The scoring model was developed based on the independent prognostic variables identified by Cox regression model. Based on the PSM-CHCC model, patients were stratified into three prognostic subgroups according to their individual score: A (scoring 0-2), B (scoring 3-5), and C (scoring > 5). The prediction performance of the PSM-CHCC model outperformed the widely accepted TNM staging system and other staging systems in both training and validation cohorts. Subgroup analysis also verified the discrimination efficacy of the PSM-CHCC model. Conclusions The newly established PSM-CHCC model may facilitate prognostic stratification and clinical decision-making in patients with cHCC-CCA.