基于ALBI分级构建术前预测肝细胞癌微血管侵犯的列线图模型OA

Objective To investigate the value of preoperative albumin-bilirubin(ALBI)grade and other clinical indicators in predicting microvascular invasion(MVI)in hepatocellular carcinoma(HCC),and to construct a preoperative predictive nomogram model based on these factors.Methods A retrospective study was conducted involving 587 HCC patients who underwent radical hepatectomy at the First Affiliated Hospital of Harbin Medical University from January 2020 to June 2024.Patients were randomly divided into a training cohort(n=410)and a validation cohort(n=177).Baseline characteristics were compared between the two cohorts to verify the balance of the grouping.Univariate and multivariate Logistic regression analyses were performed in the training cohort to identify independent risk factors for MVI,and to construct a nomogram prediction model.The performance of the prediction model was comprehensively evaluated using receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)in terms of discrimination,calibration,and clinical net benefit,respectively.Internal validation was performed in the validation cohort.Results Baseline clinicopathological characteristics were well balanced between the training cohort and the validation cohort.Multivariate Logistic regression analysis based on the training cohort showed that,decreased ALB(hypoalbuminemia),prolonged PT,ALBI grade 2,AFP≥400 ng/mL and tumor maximum diameter≥5 cm were independent risk factors for MVI.The nomogram prediction model constructed based on these factors achieved an area under the curve(AUC)of 0.770 in the training cohort and 0.795 in the validation cohort.Calibration curves indicated good consistency between the predicted probabilities and actual observations.Conclusion The preoperative nomogram model for predicting MVI based on ALBI grade demonstrates good predictive performance and clinical utility for patients with HCC.It can serve as a convenient and non-invasive tool to assist clinicians in preoperative risk stratification,and provides a reference for formulating individualized treatment strategies.