A nomogram to predict microvascular invasion in early hepatocellular carcinoma.

Abstract

To construct an integrated nomogram combining protein induced by vitamin K antagonist-II (PIVKA-II), alpha fetoprotein (AFP) and other clinical factors to detect microvascular invasion (MVI) in early hepatocellular carcinoma (HCC) patients with single nodule. One hundred and eleven early HCC patients were enrolled in the present study and 43 early HCC patients were diagnosed with MVI. Serum levels of PIVKA-II, AFP and other laboratory indicators were detected. Chi-squared test, t-test and logistic regression were employed in statistic analysis. A nomogram combining independent predictors was constructed and internal validated. In early HCC patients with MVI, PIVKA-II serum level was significantly higher than those without MVI (385.97 mAU/ml vs 67.08 mAU/ml; P < 0.01), as well as AFP serum level (81.6 ng/mL vs 9.15 ng/mL P = 0.001). PIVAK-II, AFP serum levels and tumor size were independent risk factors for MVI in early HCC, which was employed to develop a logistic regression model. The area under the ROC curve (AUROC) of the model was 0.74 (95%CI 0.65 - 0.84). A nomogram combining PIVKA-II, AFP and tumor size was constructed and calibration curves showed that the model was accurate in predicting the risk of MVI in early HCC patients. The present study indicates that a preoperative nomogram combining PIVKA-II, AFP and tumor size could estimate the preoperative probability of MVI in early HCC patients, which may help clinicians in choosing treatment options and prognosis evaluation.