文章：

筛选可从转化疗法与根治性手术序贯治疗中获益的肝细胞癌患者并构建预测模型

Screening HCC Patients Who Can Benefit from the Sequential Treatment of Conversion Therapy and Radical Surgery and Constructing a Predictive Model

原文发布日期：8 December 2025

DOI: 10.3390/cancers17243928

类型: Article

开放获取: 是

英文摘要：

Background/Objective: This study aimed to develop a new nomogram to predict the likelihood of benefit for patients with advanced HCC who can benefit from the sequential treatment of conversion therapy and radical surgery. Materials and Methods: A total of 589 patients who met the criteria were included in this study. According to a 7:3 ratio, the development group included 412 patients, while the validation group included 177 patients. The clinical outcome set for this study was whether one could benefit from radical resection after conversion therapy. Independent risk factors for the outcome were screened through univariable and multivariable Logistic regression analysis. We constructed a nomogram using independent risk factors. The areas under the receiver operating characteristic (ROC) curve, calibration curve, and clinical decision curve were used to evaluate the performance of the model. Results: Sex (OR = 2.000; 95% CI: 1.018, 3.931;p= 0.044), AFP (OR = 0.533; 95% CI: 0.313, 0.907;p= 0.020), targeted therapy and immunotherapy (OR = 3.283; 95% CI: 2.029, 5.312;p< 0.001), and postoperative TACE (OR = 6.544; 95% CI: 4.021, 10.649;p< 0.001) were identified as independent risk factors for determining whether there was a benefit. The AUCs of the nomogram for the development set and the validation set were 0.793(95% CI: 0.749–0.836) and 0.770 (95% CI: 0.697–0.844), respectively. The calibration curves and clinical decision curves of the nomogram indicate that it has good predictive performance. Conclusions: This study developed a nomogram for predicting whether HCC patients can benefit from the sequential treatment of conversion therapy and radical surgery. This is of great help for us to formulate treatment strategies for patients with advanced HCC.

摘要翻译： 

背景/目的：本研究旨在构建一个新的列线图模型，用于预测晚期肝细胞癌（HCC）患者能否从转化治疗后序贯根治性手术中获益的可能性。材料与方法：本研究共纳入589例符合标准的患者。按照7:3的比例，建模组包含412例患者，验证组包含177例患者。本研究设定的临床结局为患者能否在转化治疗后从根治性切除术中获益。通过单因素和多因素Logistic回归分析筛选出影响该结局的独立危险因素，并利用这些独立危险因素构建列线图模型。采用受试者工作特征（ROC）曲线下面积、校准曲线和临床决策曲线来评估模型的性能。结果：性别（OR = 2.000；95% CI：1.018, 3.931；p= 0.044）、甲胎蛋白（AFP）（OR = 0.533；95% CI：0.313, 0.907；p= 0.020）、靶向治疗联合免疫治疗（OR = 3.283；95% CI：2.029, 5.312；p< 0.001）以及术后经导管动脉化疗栓塞术（TACE）（OR = 6.544；95% CI：4.021, 10.649；p< 0.001）被确定为判断患者能否获益的独立危险因素。该列线图模型在建模组和验证组的曲线下面积（AUC）分别为0.793（95% CI：0.749–0.836）和0.770（95% CI：0.697–0.844）。列线图的校准曲线和临床决策曲线表明其具有良好的预测性能。结论：本研究构建了一个用于预测HCC患者能否从转化治疗序贯根治性手术中获益的列线图模型，这对于我们制定晚期HCC患者的治疗策略具有重要帮助。

原文链接：

Screening HCC Patients Who Can Benefit from the Sequential Treatment of Conversion Therapy and Radical Surgery and Constructing a Predictive Model