Retrospective Study
Copyright ©The Author(s) 2020.
World J Gastroenterol. Apr 14, 2020; 26(14): 1647-1659
Published online Apr 14, 2020. doi: 10.3748/wjg.v26.i14.1647
Table 1 Comparison of participant characteristics in the training and validation cohorts
CharacteristicTraining cohort (n = 339)Validation cohort (n = 115)P value
Median age (IQR), yr57 (49, 65)59 (51, 67)0.141
Gender
Male284 (83.8)104 (90.4)0.080
Female55 (16.2)11 (9.6)
Tumor size, cm4.5 (3.0, 8.0)4.0 (2.5, 7.0)0.095
Number of tumors
Single285 (84.1)89 (77.4)0.104
Multiple54 (15.9)26 (22.6)
Child-Pugh grade
A315 (92.9)104 (90.4)0.388
B24 (7.1)11 (9.6)
Clinical stage
I241 (71.1)80 (69.6)0.727
II86 (25.4)29 (25.2)
III12 (3.5)6 (5.2)
Etiology
Hepatitis B253 (74.6)93 (80.9)0.175
Non-hepatitis B86 (25.4)22 (19.1)
AFP, ng/mL
≤ 20142 (41.9)46 (40.0)0.122
20–4081 (23.9)38 (33.0)
≥ 400 L116 (34.2)31 (27.0)
WBC, 109/L
≤ 4.083 (24.5)33 (28.7)0.371
> 4.0256 (75.5)82 (71.3)
Neutrophils, 109/L
≤ 3.0167 (49.3)65 (56.5)0.178
> 3.0172 (50.7)50 (43.5)
PLT, 109/L
≤ 125128 (37.8)44 (38.3)0.923
> 125211 (62.2)71 (61.7)
RDW
≤ 13.0119 (35.1)54 (47.0)0.024
> 13.0220 (64.9)61 (53.0)
NLR
≤ 2.0150 (44.2)60 (52.2)0.141
> 2.0189 (55.8)55 (47.8)
PLR
≤ 100166 (49.0)65 (56.5)0.161
> 100173 (51.0)50 (43.5)
SII
≤ 300173 (51.0)66 (57.4)0.238
> 300166 (49.0)49 (42.6)
PT, sec
≤ 13.0250 (73.7)92 (80.0)0.179
> 13.089 (26.3)23 (20.0)
FIB, g/L
≤ 2.090 (26.5)24 (20.9)0.225
> 2.0249 (73.5)91 (79.1)
ALB, g/L
≤ 40192 (56.6)50 (43.5)0.015
> 40147 (43.4)65 (56.5)
ALT, U/L
≤ 40204 (60.2)77 (67.0)0.196
> 40135 (39.8)38 (33.0)
AST, U/L
≤ 35160 (47.2)62 (53.9)0.213
> 35179 (52.8)53 (46.1)
GGT, U/L
≤ 45120 (35.4)38 (33.0)0.647
> 45219 (64.6)77 (67.0)
TB, μmol/L
≤ 19257 (75.8)85 (73.9)0.683
> 1982 (24.2)30 (26.1)
ALP, g/L
≤ 120210 (61.9)71 (61.7)0.968
> 120129 (38.1)44 (38.3)
GLU, mmol/L
≤ 6.1278 (82.0)97 (84.3)0.567
> 6.161 (18.0)18 (15.7)
ALBI grade
1164 (48.4)71 (61.7)0.017
2171 (50.4)41 (35.7)
34 (1.2)3 (2.6)
MVI
Absent182 (53.7)63 (54.8)0.839
Present157 (46.3)52 (45.2)
Edmondson-Steiner classification
I–II142 (41.9)43 (37.4)0.396
III–IV197 (58.1)72 (62.6)
Table 2 Univariate logistic regression analysis of preoperative data for microvascular invasion presence in the training cohort
VariableOR (95%CI)P value
Age, yr0.981 (0.962–1.001)0.062
Gender, male vs female1.488 (0.823–2.689)0.188
Number of tumors, multiple vs single5.174 (2.611–10.252)< 0.001
Tumor size, cm1.214 (1.155–1.332)< 0.001
Etiology, non-hepatitis B vs hepatitis0.837 (0.511–1.370)0.479
AFP, ng/mL
20–40 vs ≤ 201.936 (1.100–3.407)0.022
≥ 400 vs ≤ 204.546 (2.687–7.691)< 0.001
WBC, 109/L, > 4.0 vs ≤ 4.01.117 (0.711–1.927)0.537
Neutrophils, 109/L, >3.0 vs ≤ 3.01.989 (1.289–3.069)0.002
PLT, 109/L, > 125 vs ≤ 1251.375 (0.883–2.143)0.159
RDW, > 13.0 vs ≤ 13.01.116 (0.713–1.748)0.630
NLR, > 2.0 vs ≤ 2.01.927 (1.244–2.983)0.003
PLR, > 100 vs ≤ 1001.945 (1.261–3.000)0.003
SII, > 300 vs ≤ 3002.170 (1.404–3.352)< 0.001
PT, sec, > 13 vs ≤ 131.514 (0.931–2.462)0.094
ALB, g/L, > 40 vs ≤ 400.949 (0.617–1.460)0.812
ALT, U/L, > 40 vs ≤ 400.882 (0.570–1.366)0.575
AST, U/L, > 35 vs ≤ 351.275 (0.831–1.958)0.266
GGT, U/L, > 45 vs ≤ 451.486 (0.947–2.334)0.085
TB, μmol/L, > 19 vs ≤ 191.297 (0.788–2.133)0.307
ALP, U/L, > 120 vs ≤ 1201.677 (1.078–2.610)0.022
FIB, g/L, > 2.0 vs ≤ 2.01.397 (0.852–2.290)0.185
GLU, mmol/L, > 6.1 vs ≤ 6.10.904 (0.518–1.579)0.723
ALBI grade, 1 vs 2 and 31.266 (0.825–1.942)0.281
Table 3 Multivariate logistic regression analysis of preoperative data for microvascular invasion presence in the training cohort
VariableβOR (95%CI)P value
Number of tumors, multiple vs single1.4914.441 (2.112–9.341)< 0.001
Tumor size, cm0.1781.195 (1.107–1.290)< 0.001
Neutrophils, 109/L, > 3.0 vs ≤ 3.00.5391.714 (1.036–2.836)0.036
AFP, ng/mL
20–400 vs ≤ 200.6701.955 (1.055–3.624)0.033
≥ 400 vs ≤ 201.2463.476 (1.950–6.195)< 0.001
Table 4 Accuracy of the nomogram in predicting the risk of microvascular invasion at the optimal threshold value
VariableValue (95%CI)
Training cohortValidation cohort
Sensitivity, %77.7 (71.1–84.3)69.2 (56.3–82.2)
Specificity, %70.9 (64.2–77.5)68.3 (56.4–80.1)
Positive predictive value, %69.7 (62.8–76.6)64.3 (51.3–77.2)
Negative predictive value, %78.7 (72.3–85.0)72.9 (61.2–84.6)
Positive likelihood ratio2.67 (2.10–3.40)2.18 (1.45–3.27)
Negative likelihood ratio0.31 (0.23–0.42)0.45 (0.30–0.69)
Concordance index0.79 (0.74–0.84)0.81 (0.74–0.89)
Predicted probability10.400.40