ABSTRACT
Objective:To develop and validate a nomogram model for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on preoperative enhanced computed tomography imaging features and clinical data.Methods:The clinical data of 210 patients with HCC undergoing surgery in the Second Affiliated Hospital of Anhui Medical University from May 2018 to May 2022 were retrospectively analyzed, including 172 males and 38 females, aged (59±10) years old. Patients were randomly divided into the training group ( n=147) and validation group ( n=63) by systematic sampling at a ratio of 7∶3. Preoperative enhanced computed tomography imaging features and clinical data of the patients were collected. Logistic regression was conducted to analyze the risk factors for HCC with MVI, and a nomogram model containing the risk factors was established and validated. The diagnostic efficacy of predicting MVI status in patients with HCC was assessed by receiver operating characteristic (ROC) curve, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC) of the subjects in the training and validation groups. Results:The results of multifactorial analysis showed that alpha fetoprotein ≥400 μg/ml, intra-tumor necrosis, tumor length diameter ≥3 cm, unclear tumor border, and subfoci around the tumor were independent risk factors predicting MVI in HCC. A nomogram model was established based on the above factors, in which the area under the curve (AUC) of ROC were 0.866 (95% CI: 0.807-0.924) and 0.834 (95% CI: 0.729-0.939) in the training and validation groups, respectively. The DCA results showed that the predictive model thresholds when the net return is >0 ranging from 7% to 93% and 12% to 87% in the training and validation groups, respectively. The CIC results showed that the group of patients with predictive MVI by the nomogram model are highly matched with the group of patients with confirmed MVI. Conclusion:The nomogram model based on the imaging features and clinical data could predict the MVI in HCC patients prior to surgery.
ABSTRACT
Objective To investigate natural killer(NK) and NKT cells in acute pancreatitis(AP).Methods Changes of NK and NKT cells in peripheral blood of 86 AP cases were detected using muhiparameter flow cytometry.Results Compared with control group,the NKT cells decreased in AP patients (t =5.23,P =0.00),but NK cells didn't (t =-1.15,P =0.25).NKT cells in severe SAP and mnoderate MAP were lower than that in the control group (t =-3.92,P =0.00;t =4.84,P =0.00).There was no statistically significant difference of NK cells between MAP and the controls (t =-0.54,P =0.59),but NK cells in SAP group was obviously higher than that in control group (t =3.12,P =0.00).After one week treatment,NK cells significantly decreased (t =8.43,P =0.00).NKT cells were higher than control group (t =-4.44,P =0.00).Dynamic monitoring in AP patients found continuous declination in NK cells,and NKT cells experienced an increase before a falling.Conclusion Monitoring of NK and NKT cells can be used as an important index for the severity and response to treatment in acute pancreatitis.