https://scholars.lib.ntu.edu.tw/handle/123456789/112231
標題: | TIME-VARYING PREDICTORS FOR CLINICAL SURVEILLANCE OF SMALL HEPATOCELLULAR CARCINOMA | 作者: | LIAO, CHAO-SHENG YANG, KAO-CHUN YEN, AMY, MING-FANG CHEN, TONY, HSIU-HIS 陳秀熙 |
關鍵字: | clinical surveillance;time-dependent predictor;Small hepatocellular carcinoma | 公開日期: | 2005 | 卷: | v.11 | 期: | n.3 | 起(迄)頁: | 226-233 | 來源出版物: | CANCER JOURNAL | 摘要: | Prognosis of small hepatocellular carcinoma depends on a constellation of time-varying predictors in association with liver function. We aimed to elucidate the impact of these time-dependent predictors on survival. Patients and Methods: A total of 108 patients with hepatocellular carcinoma smaller than 5 cm in diameter were recruited. Series of laboratory data and clinical assessments were retrieved from medical records. The time-dependent scoring system for the prediction of death was developed in accordance with a time- dependent Cox regression model. Results:Time trends for biologic predictors parallel cumulative survival of small hepatocellular carcinoma cases. Higher serum a-fetoprotein level was identified as the most significant time-dependent predictor. Other significant predictors included aspartate transaminase, bilirubin, alkaline phosphatase, and albumin levels and prothrombin time. Time-dependent surveillance scoring system shows the cutoff points of scores at 6 months , 1 year, 2 years, and 3 years were 42, 21, 19, and 31, respectively; the estimates of sensitivity, 100%, 100%, 100% , and 87.5%, respectively; and the estimates of specificity . 91.26%. 67.02%, 60.27%, and 78.26%, respectively. Predictive validity for this time dependent Cox regression model, particularly within 1-year of follow-up, is good. Discussion:The dynamic relationships between time-dependent predictors and risk of death were illustrated. A time- dependent predictive scoring system using these dynamic relationships was developed for real-time surveillance. [ ABSTRACT FROM AUTHOR] |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/81601 |
顯示於: | 流行病學與預防醫學研究所 |
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