Abstract：
BACKGROUND: The aim of this study was to investigate the role of thymidine kinase 1 (TK1) levels in hepatocellular carcinoma (HCC) prognosis and to develop a nomogram for predicting HCC prognosis.
METHODS: In this study, 1066 HCC patients were enrolled between August 2018 and April 2022. TK1 levels were measured within one week before enrollment, and the relationship with HCC prognosis was evaluated. Next, all patients were randomly assigned to the training set (70%, n = 746) and the validation set (30%, n = 320). We used multivariate Cox analysis to find independent prognostic factors in the training set to construct a nomogram. The predictive power of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The optimal critical value of TK1 was determined as 2.35 U/L using X-tile software.
RESULTS: Before and after propensity score matching (PSM), the median overall survival (mOS) of the low-TK1 group (< 2.35 U/L) remained significantly longer than that of the high-TK1 group (≥ 2.35 U/L) (48.1 vs 16.5 months, p < 0.001; 75.7 vs 19.8 months, p = 0.001). Moreover, multivariate Cox analysis showed that the low TK1 level was an independent positive prognostic indicator. Additionally, the area under the ROC curve for predicting the 1-year, 2-year, and 3-year survival rates was 0.770, 0.758, and 0.805, respectively.
CONCLUSIONS: TK1 could serve as a prognostic marker for HCC. In addition, the nomogram showed good predictive capability for HCC prognosis.
METHODS: In this study, 1066 HCC patients were enrolled between August 2018 and April 2022. TK1 levels were measured within one week before enrollment, and the relationship with HCC prognosis was evaluated. Next, all patients were randomly assigned to the training set (70%, n = 746) and the validation set (30%, n = 320). We used multivariate Cox analysis to find independent prognostic factors in the training set to construct a nomogram. The predictive power of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The optimal critical value of TK1 was determined as 2.35 U/L using X-tile software.
RESULTS: Before and after propensity score matching (PSM), the median overall survival (mOS) of the low-TK1 group (< 2.35 U/L) remained significantly longer than that of the high-TK1 group (≥ 2.35 U/L) (48.1 vs 16.5 months, p < 0.001; 75.7 vs 19.8 months, p = 0.001). Moreover, multivariate Cox analysis showed that the low TK1 level was an independent positive prognostic indicator. Additionally, the area under the ROC curve for predicting the 1-year, 2-year, and 3-year survival rates was 0.770, 0.758, and 0.805, respectively.
CONCLUSIONS: TK1 could serve as a prognostic marker for HCC. In addition, the nomogram showed good predictive capability for HCC prognosis.
摘要：
背景：本研究的目的是探讨胸苷激酶1（TK1）水平在肝细胞癌（HCC）预后中的作用，并建立预测HCC预后的列线图。
方法：在本研究中，在2018年8月至2022年4月之间招募了1066名HCC患者。在入组前一周内测量TK1水平，并评价其与HCC预后的关系。接下来,所有患者都被随机分配到训练组(70%，n=746)和验证集(30%，n=320）。我们使用多变量Cox分析在训练集中找到独立的预后因素以构建列线图。使用受试者工作特征（ROC）曲线评估列线图的预测能力，校正曲线,和决策曲线分析(DCA)。使用X-tile软件确定TK1的最佳临界值为2.35U/L。
结果：倾向评分匹配（PSM）前后，低TK1组（<2.35U/L）的中位总生存期（mOS）明显长于高TK1组（≥2.35U/L）（48.1vs16.5个月，p<0.001；75.7对19.8个月，p=0.001)。此外，多因素Cox分析显示，低TK1水平是独立的阳性预后指标。此外,预测1年的ROC曲线下的面积，2年,3年生存率分别为0.770、0.758和0.805。
结论：TK1可作为HCC的预后标志物。此外,列线图显示对HCC预后具有良好的预测能力.
方法：在本研究中，在2018年8月至2022年4月之间招募了1066名HCC患者。在入组前一周内测量TK1水平，并评价其与HCC预后的关系。接下来,所有患者都被随机分配到训练组(70%，n=746)和验证集(30%，n=320）。我们使用多变量Cox分析在训练集中找到独立的预后因素以构建列线图。使用受试者工作特征（ROC）曲线评估列线图的预测能力，校正曲线,和决策曲线分析(DCA)。使用X-tile软件确定TK1的最佳临界值为2.35U/L。
结果：倾向评分匹配（PSM）前后，低TK1组（<2.35U/L）的中位总生存期（mOS）明显长于高TK1组（≥2.35U/L）（48.1vs16.5个月，p<0.001；75.7对19.8个月，p=0.001)。此外，多因素Cox分析显示，低TK1水平是独立的阳性预后指标。此外,预测1年的ROC曲线下的面积，2年,3年生存率分别为0.770、0.758和0.805。
结论：TK1可作为HCC的预后标志物。此外,列线图显示对HCC预后具有良好的预测能力.
