Background:Previous studies have attempted to establish predictive models for post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC) undergoing liver resection. However, a versatile and useful predictive model for PHLF remains to be developed. Therefore, we aimed to develop predictive models for PHLF based on type IV collagen 7s domain (7s collagen) in patients with HCC.Methods:We retrospectively collected data from 972 patients with HCC who had undergone initial curative liver resection between February 2000 and December 2020 at our hospital. Multivariate logistic regression analysis using a restricted cubic spline was performed to evaluate the effect of 7s collagen on the incidence of PHLF. A nomogram was developed based on 7s collagen.Results:PHLF grades B or C were identified in 104 patients (11%): 98 (10%) and 6 (1%) PHLF grades B and C, respectively. Multivariate logistic regression analysis revealed that the preoperative serum level of 7s collagen was significantly associated with a proportional increase in the risk of PHLF, which was confirmed in both laparoscopic and open liver resections. A nomogram was developed based on 7s collagen, with a concordance index of 0.768. The inclusion of 7s collagen values in the predictive model increased the predictive accuracy.Conclusion:The findings highlight the efficacy of the serum level of 7s collagen as a predictive factor for PHLF. Our novel nomogram using 7s collagen may be useful for predicting the risk of PHLF.
背景：既往研究已尝试为接受肝切除术的肝细胞癌（HCC）患者建立肝切除术后肝功能衰竭（PHLF）的预测模型。然而，一个通用且有效的PHLF预测模型仍有待开发。因此，我们旨在基于IV型胶原7s结构域（7s胶原）为HCC患者开发PHLF预测模型。 方法：我们回顾性收集了2000年2月至2020年12月期间在我院接受初次根治性肝切除术的972例HCC患者的数据。采用限制性立方样条进行多变量逻辑回归分析，以评估7s胶原对PHLF发生率的影响。基于7s胶原开发了列线图。 结果：104例患者（11%）被确定为PHLF B级或C级：其中PHLF B级98例（10%），C级6例（1%）。多变量逻辑回归分析显示，术前血清7s胶原水平与PHLF风险的比例增加显著相关，这一发现在腹腔镜和开腹肝切除术中均得到证实。基于7s胶原开发的列线图一致性指数为0.768。将7s胶原值纳入预测模型提高了预测准确性。 结论：研究结果突显了血清7s胶原水平作为PHLF预测因素的有效性。我们使用7s胶原的新型列线图可能有助于预测PHLF风险。
肿瘤(癌症)患者之家