The Predictive Value Of ¹⁸F-FDG PET/CT SUVmax Combined With Tumor Burden Score For Postoperative Recurrence Of Hepatocellular Carcinoma

Objective:Combined with the SUVmax of ¹⁸F-FDG PET/CT and tumor burden score,to explore the risk factors the recurrence of patients after hepatectomy,a nomogram prediction model was established and its efficacy was verified.Methods:From April 2012 to December 2021,116 patients with HCC who underwent surgical resection in Shengjing Hospital affiliated to China Medical University were retrospectively analyzed.Cox regression analysis was used to screen the independent risk factors of postoperative recurrence in HCC patients.R language was used to construct nomogram that could predict 1-,2-,3-year recurrence-free survival,and the model was validated internally to evaluate the predictive power of nomogram.Results:The results of univariate Cox regression analysis showed that alpha-fetoprotein,glutamyl transaminase,portal vein tumor thrombus,SUVmax,and tumor burden score were the risk factors for postoperative recurrence of HCC patients.Multivariate Cox regression analysis showed that tumor burden score（HR=2.370,95%CI:1.354-4.150）,SUVmax（HR=1.928,95%CI:1.166-3.187）and portal vein tumor thrombus（HR=2.010,95%CI:1.068-3.782）were independent risk factors for recurrence-free survival（P<0.05）.Based on the SUVmax value,tumor burden score and portal vein tumor thrombus,a nomogram was established,the C-index of the model C index was 0.688,and the area under the ROC curve of RFS in the first,second and third years predicted by the nomogram was 0.714,0.710 and0.751,indicating that the model had high prediction efficiency.At the same time,the calibration curves of the first,second and third years were close to the diagonal curves,indicating that the prognosis evaluation model has a good calibration.The decision curves in the first,second and third years were higher than the reference line,indicating that the prediction model has good clinical effectiveness.Conclusion:SUVmax,tumor burden score and portal vein tumor thrombus were independent risk factors for postoperative recurrence of HCC.The nomogram model based on SUVmax,tumor burden score and portal vein tumor thrombus has good efficacy in predicting the recurrence of HCC patients,individualized guidance and clinical intervention of high-risk groups with tumor recurrence after HCC operation.