DataSheet_1_A novel nomogram based on GD for predicting prognosis in hepatocellular carcinoma.docx

PurposeThe prognosis of liver cancer remains unfavorable nowadays, making the search for predictive biomarkers of liver cancer prognosis of paramount importance to guide clinical diagnosis and treatment. This study was conducted to explore more prognostic markers for most HCC.
Patients and methodsA total of 330 patients were enrolled in this study according to the inclusion and exclusion criteria. Follow-up data were collected for all patients until the cutoff date of the study, February 2023. In addition, patient outcomes were assessed with progression-free survival (PFS) and overall survival (OS). All statistical analysis was conducted using R 4.2.0 software.
ResultsUnivariate analysis illustrated that the GD [the product of gamma-glutamyl transpeptidase (GGT) concentration and D-dimer concentration, GD=GGT*D-dimer] levels were related to PFS (p<0.05) and OS (p<0.05). Kaplan–Meier survival curves and log-rank tests indicated a significant difference among different levels of GD (p<0.001). Multivariate analysis demonstrated GD as an independent prognostic factor for HCC. The C-indexes of nomogram were 0.77 and 0.76 in the training or validation cohort, respectively. Area Under the Curve (AUC) of 1-, 2-, 3-, and 4-year OS showed satisfactory accuracy, and the calibration curve illustrated brilliant consistence between the ideal and predicted values.
ConclusionsHerein, it was demonstrated that GD was an independent prognostic factor for HCC and revealed the potential to predict the PFS and OS in patients with HCC. Moreover, the nomogram based on GD illustrated a satisfactory prediction ability in comparison to other models without GD.

## 研究背景与目的
目前肝癌的预后结局仍不容乐观，探寻肝癌预后预测生物标志物对于指导临床诊疗具有至关重要的意义。本研究旨在为多数肝细胞癌（Hepatocellular Carcinoma, HCC）探索更多预后相关标志物。

## 患者与研究方法
本研究按照纳入与排除标准，共纳入330例患者。所有患者均收集随访数据直至研究截止日期——2023年2月。此外，采用无进展生存期（Progression-Free Survival, PFS）与总生存期（Overall Survival, OS）对患者结局进行评估。所有统计学分析均采用R 4.2.0软件完成。

## 研究结果
单因素分析显示，γ-谷氨酰转肽酶（gamma-glutamyl transpeptidase, GGT）浓度与D-二聚体浓度的乘积（记为GD，计算公式为GD=GGT×D-二聚体）水平与无进展生存期（PFS，p<0.05）及总生存期（OS，p<0.05）显著相关。Kaplan-Meier生存曲线与log-rank检验结果表明，不同GD水平组间生存结局存在显著差异（p<0.001）。多因素分析证实，GD可作为肝细胞癌的独立预后因素。列线图（nomogram）在训练队列与验证队列中的C指数分别为0.77与0.76。1年、2年、3年及4年总生存期的受试者工作特征曲线下面积（Area Under the Curve, AUC）显示出良好的预测效能，校准曲线则证实理想预测值与实际预测值间具有极佳的一致性。

## 研究结论
本研究证实，GD可作为肝细胞癌的独立预后因素，且具备预测肝细胞癌患者无进展生存期与总生存期的潜力。此外，相较于未纳入GD的其他预测模型，基于GD构建的列线图展现出更优异的预测性能。