Construction Of Risk Factor Model Of Hepatic Alveolar Echinococcosis Complicated With Vascular Invasion

Objectives: To investigate the risk factors of hepatic alveolar hydatid disease(also known as hepatic multilocular echinococcosis,alveolar echinococcosis)complicated with vascular invasion,and to create a risk prediction model.In this study,it is proposed that the prediction system can be combined with clinical imaging technology to better assess the degree of intrahepatic vascular damage,formulate a reasonable vascular treatment method before surgery,improve the postoperative quality of life of patients,and reduce the incidence of postoperative complications.Methods: The clinical data of 237 patients with HAE in the Affiliated Hospital of Qinghai University from January 2015 to October 2020 were retrospectively analyzed,and they were divided into vascular invasion group(161 cases)and non-vascular invasion group(76 cases)according to the presence or absence of vascular invasion.Including age,sex,hepatitis history,liver function Child-Pugh grading,alanine aminotransferase(ALT),Aspartate aminotransferase(AST),AST to platelet ratio(APRI),albumin(ALB),total bilirubin(TB),alkaline phosphatase(ALP),glutamine transpeptidase(GGT),platelet count(PLT),prothrombin time(PT),neutrophil-lymphocyte ratio(NLR),PLT to lymphocyte ratio(PLR),eosinophils(E),neutrophils(N),neutrophils(N),lesion location,number of lesions,lesion size.The risk factors of HAE complicated with vascular invasion were analyzed by univariate and multivariate logistic regression,and to establish a risk prediction model for vascular invasion of hepatic alveolar hydatid.The fit of the prediction model was evaluated by Hosmer-Lemeshow test,and the predictive value of the model was evaluated by receiver operating characteristic(ROC)curve.Results: The incidence of vascular invasion in this group was 67.9%(161/237).Multivariate Logistic regression statistics showed that age > 34.5 years(area under the ROC curve was 0.623,sensitivity was 0.640,specificity was 0.605),and the lesion diameter was > 9.655 cm(area under the ROC curve was0.810,sensitivity was 0.739,specificity was 0.882),the location of the lesion(right half liver,spanning left and right half liver)(area under the ROC curve was 0.639,sensitivity was 0.516,specificity was 0.803),ALT>18.5U/L(area under the ROC curve was 0.660,sensitivity was 0.882)0.820,specificity 0.500),PLR>173.04(area under the ROC curve 0.644,sensitivity 0.484,specificity 0.803)were independent risk factors for HAE complicated with vascular invasion.These 5 independent risk factors were incorporated into the logistic regression equation: Logit(P)=Ln(P/(1-P))=11.653+1.198X(age)+2.8X(lesion diameter)+1.507X(lesion location)+ 1.172X(ALT)+1.375X(PLR).The incidence of hepatic alveol ar hydatid vascular invasion in HAE patients was obtained.The area under cur ve(AUC)of the receiver operating characteristic curve of the joint predictionm odel was 0.891,the sensitivity was 0.845 and the specificity was 0.829.Conclution:Age>34.5 years old,lesion diameter>9.655 cm,lesion location(right half liver,spanning left and right half liver),ALT>18.5U/L,PLR>173.04 are independent risk factors for HAE complicated with vascular invasion.According to regression analysis The established prediction model can effectively predict the occurrence of HAE complicated with vascular invasion.