Tu HB, Chen LH, Huang YJ, Feng SY, Lin JL, Zeng YY. Novel model combining contrast-enhanced ultrasound with serology predicts hepatocellular carcinoma recurrence after hepatectomy. World J Clin Cases 2021; 9(24): 7009-7021 [PMID: 34540956 DOI: 10.12998/wjcc.v9.i24.7009]
Corresponding Author of This Article
Yong-Yi Zeng, MD, PhD, Professor, Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312 Xihong Road, Fuzhou 350025, Fujian Province, China. lamp197311@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hai-Bin Tu, Li-Hong Chen, Yu-Jie Huang, Si-Yi Feng, Jian-Ling Lin, Department of Ultrasound, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
Yong-Yi Zeng, Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, Fujian Province, China
Author contributions: Tu HB designed and performed the research, and wrote and analyzed the paper; Chen LH, Huang YJ, and Feng SY designed the research, collected the data, and supervised the report; Lin JL provided clinical advice; and Zeng YY supervised the report.
Supported byStartup Fund for Scientific Research, Fujian Medical University, No. 2019QH1302.
Institutional review board statement: The study was reviewed and approved by the Mengchao Hepatobiliary Hospital of Fujian Medical University Institutional Review Board (No. 2010_010_01).
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Yi Zeng, MD, PhD, Professor, Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312 Xihong Road, Fuzhou 350025, Fujian Province, China. lamp197311@126.com
Received: March 13, 2021 Peer-review started: March 13, 2021 First decision: June 3, 2021 Revised: June 12, 2021 Accepted: July 5, 2021 Article in press: July 5, 2021 Published online: August 26, 2021 Processing time: 163 Days and 12.6 Hours
ARTICLE HIGHLIGHTS
Research background
Surgery is the main treatment for hepatocellular carcinoma (HCC). However, 30%-50% of patients develop recurrence within 2 years, which is the main cause of death.
Research motivation
Screening patients with high recurrence risk plays an important role in making reasonable clinical decisions.
Research objectives
To combine contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LIRADS) with serology biomarkers to construct a non-invasive model predicting the early recurrence of HCC, and verify the model.
Research methods
Records of 744 consecutive patients undergoing first-line curative surgery for HCC in one institution from 2016–2018 were reviewed, and 292 local patients were selected for analysis. General characteristics, CEUS liver imaging reporting and data system (LIRADS) parameters, and serology biomarkers were collected. Univariate analysis and multivariate analyses were performed to evaluate the independent prognostic factors for tumor recurrence. Then, a nomogram called CEUS model was constructed. The CEUS model was then used to predict recurrence at 6 mo, 12 mo, and 24 mo.
Research results
Tumor diameter, preoperative alpha-fetoprotein (AFP) level, and LIRADS were identified to be independent hazard factors, with a hazard ratio of 1.123 (95% confidence interval [CI]: 1.041-1.211), 1.547 (95%CI: 1.245-1.922), and 1.428 (95%CI: 1.059-1.925), separately. A nomogram based on them was constructed; the cut-off value at 6 mo, 12 mo, and 24 mo was 100, 80, and 50, and the C-index was 0.748 (95%CI: 0.683-0.813), 0.762 (95%CI: 0.704-0.820), and 0.762 (95%CI: 0.706-0.819), separately. The calibration at 6 mo was desirable; however, the calibration at 12 and 24 mo should be improved.
Research conclusions
The CEUS model can screen out patients who have a high recurrence risk, it is helpful for making reasonable treatment strategy.
Research perspectives
A multi-center study, with an expanded sample size and prospective verification, is required.
