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Role of the Clinical Features and MRI Parameters on Ki-67 Expression in Hepatocellular Carcinoma Patients: Development of a Predictive Nomogram

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Abstract

Purpose

To develop a nomogram using clinical features and the MRI parameters for preoperatively predicting the expression of Ki-67 in patients with hepatocellular carcinoma (HCC).

Methods

One hundred and forty patients (training cohorts: n = 108; validation cohorts: n = 32) with confirmed HCC were investigated. Mann–Whitney U test, independent sample t-test, and chi-squared test were used to analyze the continuous and categorical variables. Univariate and multivariate logistic regression analyses were performed to examine the clinical variables and parameters from MRI associated with Ki-67 expression. As a result, a nomogram was developed based on these associations in patients with HCC. The performance of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC) and calibration curves.

Results

In the training set, multivariable logistic regression analysis revealed that lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) levels, protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels, and tumor shape were independent predictors for Ki-67 expression (p < 0.05). These three variables and the apparent diffusion coefficient (ADC) value were used to establish a nomogram, while the ADC value was found to be a marginal significant predictor. The model demonstrated a strong ability to discriminate Ki-67 expression in both the training and validation cohorts (AUC = 0.862, 0.877).

Conclusion

A non-invasive preoperative prediction method, which incorporates MRI variables and clinical features was developed, and showed effectiveness in evaluating Ki-67 expression in HCC patients.

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Availability of Data and Materials

The datasets generated and/or analyzed during the current study are not publicly available due to our next research involving some data, but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Radiology, Tian** Third Central Hospital, Tian**, China

    Ming-ge Li

  2. Department of Radiology, Shengli Oilfield Central Hospital, No. 31 **an Road, Dongying District, Dongying, 257034, Shandong Province, China

    Shu-bin Luo, Lei Li & Hai-lian Lyu

  3. Department of Pathology, Shengli Oilfield Central Hospital, Dongying, Shandong Province, China

    Ying-ying Hu

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Contributions

L.MG. wrote the main manuscript text, L.SB. and L.HL. prepared data, and H.YY. and L.L. prepared figures 2. All authors reviewed the manuscript.

Corresponding author

Correspondence to Hai-lian Lyu.

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This retrospective study was approved by the Institutional Ethics Committee of the Shengli Oilfield Central Hospital, which waived the requirement for written informed consent.

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The authors declare no competing interests.

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Li, Mg., Luo, Sb., Hu, Yy. et al. Role of the Clinical Features and MRI Parameters on Ki-67 Expression in Hepatocellular Carcinoma Patients: Development of a Predictive Nomogram. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01051-5

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