Work

MRI Features and Neutrophil-to-Lymphocyte Ratio (NLR)-Based Nomogram to Predict Prognosis of Microvascular Invasion-Negative Hepatocellular Carcinoma

Year: 2025

Type: article

Abstract: Purpose: This study aimed to develop a novel nomogram to predict recurrence-free survival (RFS) for microvascular invasion (MVI)-negative hepatocellular carcinoma (HCC) patients after curative resection. Patients and Methods: A total of 143 pathologically confirmed MVI-negative HCC patients were analyzed retrospectively. Baseline MRI features and inflammatory markers were collected. We used univariable and multivariable Cox regression analysis to identify the independent risk factors for RFS. And we established a nomogram based on significant MRI features and inflammatory marker. The receiver operating characteristic (ROC) curve, concordance index (C-index) and calibration curve were used to evaluate the predictive accuracy and discriminative ability of the nomogram. The decision curve analysis (DCA) was performed to validate the clinical utility of the nomogram. Results: In multivariate Cox regression analysis, neutrophil-to-lymphocyte ratio (NLR) (P = 0.018), tumor size (P = 0.002), and tumor capsule (P = 0.000) were independent significant variables associated with RFS. Nomogram with independent factors was developed and achieved a good C-index of 0.730 (95% confidence interval [CI]: 0.656– 0.804) for predicting RFS. In ROC analysis, the areas under curve of the nomogram for 1-, 3- and 5-year RFS prediction were 0.725, 0.784 and 0.798, respectively. The risk score calculated by nomogram could divide MVI-negative HCC patients into high-risk group or low-risk group (P < 0.0001). DCA analysis revealed that the nomogram could increase net benefit and exhibited a wider range of threshold probabilities by the risk stratification than the independent risk factors in the prediction of MVI-negative HCC recurrence. Conclusion: The nomogram prognostic model based on MRI features and NLR for predicting RFS showed high accuracy in MVI-negative HCC patients after curative resection. It can help clinicians make treatment decisions for MVI-negative HCC patients and identify high-risk patients for timely intervention. Plain Language Summary: The lack of prognostic studies for microvascular invasion (MVI)-negative HCC patients after hepatectomy poses a great challenge to clinical management. To bridge this gap, our team conducted extensive research and developed a customized prognostic nomogram specifically for this patient subgroup. We created a predictive model that relies on MRI features (tumor size and tumor capsule) and neutrophil-to-lymphocyte ratio (NLR). This model demonstrates high accuracy in predicting outcomes for MVI-negative HCC patients following curative resection. And our model aids clinicians in making treatment decisions for MVI-negative HCC patients and in identifying high-risk patients for timely intervention. Keywords: hepatocellular carcinoma, microvascular invasion-negative, neutrophil-to-lymphocyte ratio, recurrence-free survival

Source: Journal of Hepatocellular Carcinoma

DOI: 10.2147/jhc.s486955

Authors: Yunyun Wei, Xuegang Huang, Wei Pei, Yang Zhao, Hai Liao

Institutions: Guangxi Medical University, Tumor Hospital of Guangxi Medical University

Language: English

Topic: Hepatocellular Carcinoma Treatment and Prognosis

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836