School of Basic Medicine, Shandong First Medical University, Jinan, China.Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.Affiliations
Objective: This study aims to establish a nomogram and provide an effective method to distinguish between intrahepatic cholangiocarcinoma and hepatocellular carcinoma . Methods: A total of 1,591 patients with HCC or ICC hospitalized at Shandong Provincial Hospital between January 2016 and August 2021 were included and randomly divided into development and validation groups in a ratio of 3:1. Univariate and multivariate analyses were performed to determine the independent differential factors be...更多
Objective: This study aims to establish a nomogram and provide an effective method to distinguish between intrahepatic cholangiocarcinoma and hepatocellular carcinoma . Methods: A total of 1,591 patients with HCC or ICC hospitalized at Shandong Provincial Hospital between January 2016 and August 2021 were included and randomly divided into development and validation groups in a ratio of 3:1. Univariate and multivariate analyses were performed to determine the independent differential factors between HCC and ICC patients in the development cohort. By combining these independent differential factors, the nomogram was established for discriminating ICC from HCC. The accuracy of the nomogram was estimated by using receiver operating characteristic curve and decision curve analysis . Furthermore, the predictive nomogram was assessed in the internal testing set. Results: Through multivariate analysis, independent differential factors between HCC and ICC involved hepatitis B virus , logarithm of alpha-fetoprotein , logarithm of protein induced by vitamin K absence or antagonist-II , logarithm of carbohydrate antigen 199 , and logarithm of carbohydrate antigen 125 . A nomogram was finally established by incorporating these five independent differential factors. Comparing a model of conventional tumor biomarkers including AFP and CA199, the nomogram showed a better distinction between ICC and HCC. The area under the ROC curve of ICC diagnosis was 0.951 for the nomogram. The results were consistent in the validation cohort with an AUC of 0.958 . After integrating patient preferences into the analysis, the DCA showed that using this nomogram to distinguish ICC and HCC increased more benefit compared with the conventional model. Conclusion: An efficient nomogram has been established for the differential diagnosis between ICC and HCC, which may facilitate the detection and diagnosis of ICC. Further use of the nomogram in multicenter investigations will confirm the practicality of the tool for future clinical application.收起
