Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Abstract Objective To establish nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Methods A cohort of 422 patients with HCC or ICC hospitalized at Xiangya Hospital between January 2014 and December 2018 was included...

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Main Authors: Lang Chen, Furong Zeng, Lei Yao, Tongdi Fang, Mengting Liao, Jing Long, Liang Xiao, Guangtong Deng
Format: Article
Language:English
Published: Wiley 2020-02-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.2823
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author Lang Chen
Furong Zeng
Lei Yao
Tongdi Fang
Mengting Liao
Jing Long
Liang Xiao
Guangtong Deng
author_facet Lang Chen
Furong Zeng
Lei Yao
Tongdi Fang
Mengting Liao
Jing Long
Liang Xiao
Guangtong Deng
author_sort Lang Chen
collection DOAJ
description Abstract Objective To establish nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Methods A cohort of 422 patients with HCC or ICC hospitalized at Xiangya Hospital between January 2014 and December 2018 was included in the study. Univariate and multivariate analysis was performed to identify the independent differential factors. Through combining these independent differential factors, a nomogram was established for differential diagnosis between ICC and HCC. The accuracy of nomogram was evaluated by using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). The results were validated using a prospective study on 98 consecutive patients operated on from January 2019 to November 2019 at the same institution. Results Sex (OR = 9.001, 95% CI: 3.268‐24.792, P < .001), hepatitis (OR = 0.323, 95% CI: 0.121‐0.860, P = .024), alpha‐fetoprotein (AFP) (OR = 0.997, 95% CI: 0.995‐1.000, P = .046), carbohydrate antigen 19‐9 (CA199) (OR = 1.016, 95% CI: 1.007‐1.025, P < .001), and aspartate transaminase‐to‐neutrophil ratio index (ANRI) (OR = 0.904, 95% CI: 0.843‐0.969, P = .004) were the independent differential factors for ICC. Nomogram was established with well‐fitted calibration curves through incorporating these 5 factors. Comparing model 1 including gender, hepatitis, AFP, and CA199 (C index = 0.903, 95% CI: 0.849‐0.957) and model 2 enrolling AFP and CA199 (C index = 0.850, 95% CI: 0.791‐0.908), the nomogram showed a better discrimination between ICC and HCC, with a C index of 0.920 (95% CI, 0.872‐0.968). The results were consistent in the validation cohort. DCA also confirmed the conclusion. Conclusion A nomogram was established for the differential diagnosis between ICC and HCC preoperatively, and better therapeutic choice would be made if it was applied in clinical practice.
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spelling doaj.art-2f8539e1556e4223b51c8357030c100a2023-04-13T04:51:24ZengWileyCancer Medicine2045-76342020-02-01941451146110.1002/cam4.2823Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinomaLang Chen0Furong Zeng1Lei Yao2Tongdi Fang3Mengting Liao4Jing Long5Liang Xiao6Guangtong Deng7Xiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaXiangya Hospital Central South University Changsha ChinaAbstract Objective To establish nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Methods A cohort of 422 patients with HCC or ICC hospitalized at Xiangya Hospital between January 2014 and December 2018 was included in the study. Univariate and multivariate analysis was performed to identify the independent differential factors. Through combining these independent differential factors, a nomogram was established for differential diagnosis between ICC and HCC. The accuracy of nomogram was evaluated by using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). The results were validated using a prospective study on 98 consecutive patients operated on from January 2019 to November 2019 at the same institution. Results Sex (OR = 9.001, 95% CI: 3.268‐24.792, P < .001), hepatitis (OR = 0.323, 95% CI: 0.121‐0.860, P = .024), alpha‐fetoprotein (AFP) (OR = 0.997, 95% CI: 0.995‐1.000, P = .046), carbohydrate antigen 19‐9 (CA199) (OR = 1.016, 95% CI: 1.007‐1.025, P < .001), and aspartate transaminase‐to‐neutrophil ratio index (ANRI) (OR = 0.904, 95% CI: 0.843‐0.969, P = .004) were the independent differential factors for ICC. Nomogram was established with well‐fitted calibration curves through incorporating these 5 factors. Comparing model 1 including gender, hepatitis, AFP, and CA199 (C index = 0.903, 95% CI: 0.849‐0.957) and model 2 enrolling AFP and CA199 (C index = 0.850, 95% CI: 0.791‐0.908), the nomogram showed a better discrimination between ICC and HCC, with a C index of 0.920 (95% CI, 0.872‐0.968). The results were consistent in the validation cohort. DCA also confirmed the conclusion. Conclusion A nomogram was established for the differential diagnosis between ICC and HCC preoperatively, and better therapeutic choice would be made if it was applied in clinical practice.https://doi.org/10.1002/cam4.2823aspartate transaminase‐to‐neutrophil ratio index (ANRI)differential diagnosishepatocellular carcinoma (HCC)intrahepatic cholangiocarcinoma (ICC)nomogram
spellingShingle Lang Chen
Furong Zeng
Lei Yao
Tongdi Fang
Mengting Liao
Jing Long
Liang Xiao
Guangtong Deng
Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
Cancer Medicine
aspartate transaminase‐to‐neutrophil ratio index (ANRI)
differential diagnosis
hepatocellular carcinoma (HCC)
intrahepatic cholangiocarcinoma (ICC)
nomogram
title Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
title_full Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
title_fullStr Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
title_full_unstemmed Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
title_short Nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
title_sort nomogram based on inflammatory indices for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma
topic aspartate transaminase‐to‐neutrophil ratio index (ANRI)
differential diagnosis
hepatocellular carcinoma (HCC)
intrahepatic cholangiocarcinoma (ICC)
nomogram
url https://doi.org/10.1002/cam4.2823
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