ObjectiveTo analyze the risk factors and develop a nomagram predictive model for early recurrence after curative resection for hepatocellular carcinoma (HCC). MethodsThe clinicopathologic data of the patients with HCC who underwent radical hepatectomy at the First Affiliated Hospital of Xinjiang Medical University from August 2017 to August 2021 were retrospectively collected. The univariate and multivariate logistic regression analysis were used to screen for the risk factors of early recurrence for HCC after radical hepatectomy, and a nomogram predictive model was established based on the risk factors. The receiver operating characteristic (ROC) curve and calibration curve were used to validate the predictive performance of the model, and the decision curve analysis (DCA) curve was used to evaluate its clinical practicality. ResultsA total of 302 patients were included based on the inclusion and exclusion criteria, and 145 (48.01%) of whom experienced early recurrence. The results of multivariate logistic regression model analysis showed that the preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), γ-glutamate transferase (GGT), alpha fetoprotein (AFP), tumor size, and microvascular invasion (MVI) were the influencing factors of early recurrence for HCC after radical resection (P<0.05). The nomogram was established based on the risk factors. The area under the ROC curve of the nomogram was 0.858 [95%CI (0.816, 0.899)], and the Brier index of the calibration curve of the nomogram was 0.152. The predicted result of the nomogram was relatively close to the true result (Hosmer-Lemeshow test, P=0.913). The DCA result showed that the clinical net benefit of intervention based on the predicted probability of the model was higher than that of non-intervening in all HCC patients and intervening in all HCC patients when the threshold probability was in the range of 0.1 to 0.8. ConclusionsThe results of this study suggest that for the patients with the risk factors such as preoperative NLR greater than 2.13, PLR greater than 108.15, GGT greater than 46.0 U/L, AFP higher than 18.96 μg/L, tumor size greater than 4.9 cm, and presence of preoperative MVI need to closely pay attention to the postoperative early recurrence. The nomogram predictive model constructed based on these risk factors in this study has a good discrimination and accuracy, and it could obtain clinical net benefit when the threshold probability is 0.1 to 0.8.
ObjectiveThis study aims to summarize the risk factors and therapeutic strategies for early recurrence after hepatocellular carcinoma (HCC) resection, so as to provide a reference for the prediction of postoperative early recurrence and the treatment of recurrent HCC. MethodsThe article gives a summary of the risk factors for early recurrence and treatment after hepatectomy for HCC by searching for relevant studies at home and abroad in recent years. ResultsHCC is a common and highly fatal malignant tumor worldwide. Surgical resection remains the preferred treatment method, but the early recurrence rate (recurrence within 2 years after surgery) is as high as 40%-50%, which seriously affects the prognosis of patients. The risk factors for early recurrence of HCC include patient factors (gender, marital status, liver status, inflammatory indicators, nutritional status, etc.), tumor factors (tumor markers, diameter, number, degree of differentiation, margin and capsule, microvascular invasion, satellite nodules, etc.) and surgical factors (whether anatomical resection or not, resection margin, perioperative blood transfusion, etc.); treatment methods include reoperation (laparoscopic, open), salvage liver transplantation, radiofrequency ablation, interventional therapy (transarterial chemoembolization, transhepatic arterial infusion chemotherapy, transarterial radioembolization) and systemic therapy (targeted immunotherapy, antiviral therapy and traditional Chinese medicine therapy). ConclusionEarly recurrence after HCC hepatectomy severely compromises the long-term survival of patients. Going forward, efforts should be devoted to developing accurate prediction models for postoperative early recurrence, further clarifying the optimal therapeutic regimens for recurrent HCC under different clinical scenarios, and providing evidence for individualized treatment to improve the overall prognosis of patients.
ObjectiveTo detect the expression of FXYD domain-containing ion transport regulator 6 (FXYD6) protein in hepatocellular carcinoma tissues and the corresponding paracancerous liver tissues, and to explore the clinical significance of FXYD6 protein expression in hepatocellular carcinoma.MethodsEighty hepatocellular carcinoma tissues and the corresponding 40 paracancerous tissues were retrospectively collected in Cangzhou Central Hospital from March 2012 to January 2018, and the expression of FXYD6 protein was examined in these tissues by strept avidin-biotin complex (SABC) immunohistochemistry. We analyzed the relationship between the expression of FXYD6 protein and clinicopathological characteristics of the patients with hepatocellular carcinoma, and the relationship between the expression of the protein and early recurrence or overall survival.ResultsThe positive expression rate of FXYD6 protein was statistically higher in hepatocellular carcinoma tissues than that in the corresponding paracancerous tissues [77.5% (62/80) vs. 40.0% (16/40), P<0.001]. Its expression in hepatocellular carcinoma was not related with gender, age, histological differentiation, tumor maximum diameter, tumor number, AFP concentration in serum, and HBV or HCV infection (P>0.05), but with integrity of tumor capsule, microvascular invasion, and tumor stage (P<0.05). The positive FXYD6 protein expression group had a significantly higher recurrence rate than that of the negative FXYD6 protein expression group [53.2% (33/62) vs. 16.7% (3/18), P=0.006]. However, multivariate analysis results showed that high FXYD6 protein expression was not a risk factor for early relapse (P=0.422). The positive FXYD6 protein expression group had a significantly shorter postoperative survival than the negative FXYD6 expression group ( P=0.043). However, multivariate analysis results showed high FXYD6 protein expression was not a risk factor for overall survival (P=0.754).ConclusionsFXYD6 protein was expressed abnormally in hepatocellular carcinoma tissues, which might be involved in the carcinogenesis and the progression of hepatocellular carcinoma. It might be a poor prognostic factor for patient with hepatocellular carcinoma.