title: The prognostic values of 12 cirrhosis-relative noninvasive models in patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinogenesis is associated with the progression of cirrhosis, and the latter further aggravates tumor development and prognosis. The aim of the study was to investigate the prognostic values of 12 cirrhosis-relative noninvasive models in hepatocellular carcinoma (HCC).
  
  
  METHODS
  We retrospectively analyzed 363 HCC patients who either underwent partial hepatectomy (PH) or received transcatheter arterial chemoembolization (TCAE). Preoperative data were collected to calculate these indices using the original formulas. Diagnostic accuracy of these models in detection of cirrhosis was evaluated by area under receiver operating characteristic curve (AUC) analysis. Multivariate analyses were performed to assess the independent prognostic significance of the 12 indicators.
  
  
  RESULTS
  Aspartate aminotransferase-platelet ratio index (APRI) and Goteborg University Cirrhosis Index (GUCI) were found to be significant in discriminating cirrhotic patients from non-cirrhotic individuals. When the indices were expressed as continuous variables, multivariate analyses indicated that APRI and GUCI were independent indices to predict overall survival in patients underwent PH, with a hazard ratio (HR) value 1.04 (p = 0.005) and 1.07 (p = 0.001), respectively. In the cohort of TACE, APRI and GUCI were independently associated with survival as well.
  
  
  CONCLUSIONS
  Of the 12 indices, APRI and GUCI were relatively accurate predictors of cirrhosis status as well as outcome of HCC. As only a limited study population was enrolled in the current study, larger cohorts are needed to validate our results.
authors.affiliation: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University College of Medicine , Xi'an, Shaanxi Province , China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Pang
authors.forename: Jing-Yao
authors.initials: JY
authors.lastname: Zhang
authors.forename: Xin-Sen
authors.initials: XS
authors.lastname: Xu
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Song
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Zhou
authors.forename: Run-Chen
authors.initials: RC
authors.lastname: Miao
authors.forename: Kai
authors.initials: K
authors.lastname: Qu
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Liu
authors.forename: Ya-Feng
authors.initials: YF
authors.lastname: Dong
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000401:mortality / Q000473:pathology*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies
keywords: Liver cirrhosis; alkaline phosphatase; blood platelets; gamma-glutamyltransferase; hepatectomy; hepatocellular carcinoma; survival