目的:肝移植是早期肝细胞癌和肝硬化患者的最佳治疗方法。然而,大约15%的人肝细胞癌复发。本研究旨在评估肝移植后肝细胞癌复发预测模型的有效性。
方法:这项回顾性研究包括381例HCC患者,并评估了以下模型的性能:R3-AFP评分,甲胎蛋白(AFP)模型,加州大学,洛杉矶(UCLA)列线图,肝移植(MORAL)后复发的前模型,Post-Moral,和组合道德模型,肿瘤复发(RETREAT)模型和血小板与淋巴细胞比率(PLR)模型的风险估计。
结果:R3-AFP评分,加州大学洛杉矶分校列线图,AFP模型,撤退,组合道德,和后道德模型表现出可比的AUROC,范围从0.785到0.733。R3-AFP模型和AFP模型的AUROC优于Pre-MORAL和PLR模型的AUROC。加州大学洛杉矶分校的列线图,退缩得分,组合模型,和Post-MORAL模型类似于前两个模型,但仅优于PLR模型。
结论:R3-AFP模型,加州大学洛杉矶分校列线图,AFP模型,撤退,组合道德,和MORAL后模型显示了移植后肝细胞癌复发的中等预测能力。这些模型在预测复发的能力方面没有观察到显著差异。
OBJECTIVE: Liver transplantation is the optimal treatment for patients with early
hepatocellular carcinoma and cirrhosis. However,
hepatocellular carcinoma recurs in approximately 15 % of individuals. This
study aimed to assess the efficacy of predictive models for
hepatocellular carcinoma recurrence after liver transplantation.
METHODS: This retrospective
study included 381 patients with HCC and evaluated the performance of the following models: R3-AFP score, alpha-fetoprotein (AFP) model, University of California, Los Angeles (UCLA) nomogram, Pre-Model of Recurrence after Liver Transplantation (MORAL), Post-MORAL, and Combo MORAL models, Risk Estimation of Tumor Recurrence (RETREAT) model and Platelet to Lymphocyte Ratio (PLR) model.
RESULTS: The R3-AFP score, UCLA nomogram, AFP model, RETREAT, Combo MORAL, and Post-MORAL models exhibited comparable AUROCs, ranging from 0.785 to 0.733. The AUROCs for the R3-AFP model and AFP model were superior to those of the Pre-MORAL and PLR models. The UCLA nomogram, RETREAT score, Combo MORAL model, and Post-MORAL model performed similarly to the first two models, but were only superior to the PLR model.
CONCLUSIONS: The R3-AFP model, UCLA nomogram, AFP model, RETREAT, Combo MORAL, and Post-MORAL models demonstrated a moderate predictive capacity for
hepatocellular carcinoma recurrence following transplantation. No significant differences were observed among these models in their ability to predict recurrence.