A scoring model based on plasma fibrinogen concentration for predicting recurrence of hepatocellular carcinoma after liver transplantation

摘要

Background We investigated the prognostic value of preoperative fibrinogen levels in hepatocellular carcinoma patients receiving liver transplantation by building a scoring model for predicting tumor recurrence. Methods Cox regression analysis was used to identify factors that predicted tumor recurrence, and a scoring model was generated by assigning a value of 0 or 1 to each independent risk factor. The cut-off value for fibrinogen was determined by receiver operating characteristic curve analysis. Results Preoperative fibrinogen concentration was significantly higher in patients with vs. without tumor recurrence (3.27?g/L vs. 2.34?g/L, P ??0.001), with vs. without macrovascular invasion (3.54?g/L vs . 2.82?g/L, P?= 0.007), and with 400 vs. ≤400?ng/mL plasma alpha-fetoprotein concentration (3.43?g/L vs . 2.76?g/L, P?= 0.007). The 5-year disease-free survival rate was significantly lower for patients with elevated (≥2.68?g/L) vs. normal (2.68?g/L) fibrinogen concentration (37.2% vs . 78.4%, P ?=?0.001). Macrovascular invasion, 3 tumor nodules, and elevated fibrinogen concentration were independent risk factors for tumor recurrence. A scoring model based on these risk factors predicted recurrence with a sensitivity of 68.3% and a specificity of 87.5%. Conclusions Elevated preoperative plasma fibrinogen concentration is associated with tumor recurrence in HCC patients after liver transplantation. A new scoring model predicted recurrence with good sensitivity and specificity.