Study On Risk Assessment Model Of Hepatocellular Carcinoma Associated With Chronic Viral Hepatitis B Based On EMR Data Analysis

Purpose : The purpose of this study was to establish a risk assessment model for patients with chronic hepatitis B virus(HBV)infection-related liver cancer from both Chinese and western medicine,to provide data and methods for early prevention and treatment of liver cancer.Methods: Based on the data of 600 cases collected in this study,the patients were divided into modeling group(450 cases)and validation group(150 cases)according to the randomization number 3:1.The influencing factors of HBV-associated liver cancer were analyzed by univariate binary logistic regression analysis.The influencing factors were screened by stepwise forward binary logistic regression analysis to establish a risk assessment model for HBV-associated liver cancer.The area under ROC curve(AUC)was calculated for the modeling group and the verification group to evaluate the prediction accuracy.Result: According to univariate binary logistic regression analysis,age,gender,family tumor history,alcohol consumption history,cirrhosis,diabetes,HBV DNA quantitative,PLT quantitative,tongue color(dark red tongue,purple dark tongue)and tongue coating(yellow and thick coating)were the risk factors for HBV infecting associated liver cancer.According to multivariate binary logistic regression analysis,the independent risk factors of five variables including age,sex,cirrhosis,HBV DNA quantification,and tongue color were identified.The final risk prediction model was as follows: predictive value of HCC occurrence =0.654* age(age ≥47.5 years old,1;Age <47.5 years old,0)+0.610* sex(male =1;Female =0)+0.801*HBV DNA quantitation(≥5.4log10copies/ml,1;<5.4log10copies/ml,0)+1.551* cirrhosis *(was =1;No =0)+0.870*dark red tongue(yes =1,no =0)+0.799* purple dark tongue(yes =1;No =0),the score range is 0 to 4.486,the higher the score,the greater the risk.To facilitate calculation,a risk scoring system was established: 1 point for age ≥47.5 years old;<47.5 years old 0 points,gender: male 1 point;Female 0,cirrhosis of the liver: 2;Negative 0 score,HBV DNA quantitation: ≥5.4log10copies/ml 1 score;<5.4log10copies/ml 0 points,dark red tongue:is 1 points;No 0,purple dark tongue: is 1;No 0.The scoring system has a score range of0-6,with a dividing line of 4,with ≥4 for high-risk groups and < 4 for low-risk groups.Conclusion: The model was verified by goodness of fit test and ROC curve comparison to show that the model predicted a high degree of calibration and accuracy.The risk assessment model for HBV infection-related liver cancer established by age,gender,cirrhosis,HBV DNA quantification and tongue color is simple,practical and has the characteristics of traditional Chinese medicine.It has high clinical practical value and is worthy of clinical promotion and application.