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SR-HCC Score: A Novel Nomogram for Predicting Spontaneous Rupture in Hepatocellular Carcinoma Patients
Siyuan Gao1, Xiuling Zhang1, Ting Jia1
1Liver Center, The Third People's Hospital of Kunming, Kunming, Yunnan, 650041, People's Republic of China.
Insights
A new SR-HCC score predicts spontaneous rupture in hepatocellular carcinoma (HCC) patients. This tool aids early intervention, improving outcomes and preventing life-threatening ruptures.
Area of Science:
- Hepatology
- Oncology
- Medical Diagnostics
Background:
- Spontaneous rupture of hepatocellular carcinoma (srHCC) is a critical complication with high mortality.
- Currently, no integrated predictive tool exists for stratifying srHCC risk.
- Early identification of high-risk patients is crucial for timely intervention.
Purpose of the Study:
- To develop and validate a novel nomogram, the SR-HCC score, for predicting srHCC risk.
- To integrate clinical, radiological, and laboratory parameters into a predictive model.
- To provide a user-friendly tool for individualized risk stratification.
Main Methods:
- Retrospective cohort study of 186 HCC patients, split into training (80%) and validation (20%) sets.
- Logistic regression analyses identified independent predictors of srHCC.
- Nomogram performance evaluated using Receiver Operating Characteristic (ROC) curves and calibration plots.
Main Results:
- Key predictors included tumor diameter, number of tumors, capsular protrusion, Alpha-Fetoprotein (AFP) levels, and changes in ALT and AST.
- The SR-HCC score demonstrated excellent discrimination (AUC = 0.9617 training, 0.9630 validation).
- The nomogram showed good calibration, with predicted probabilities closely matching observed outcomes.
Conclusions:
- The SR-HCC score is a reliable and user-friendly tool for srHCC risk stratification.
- This tool can guide preventive interventions and surveillance strategies, particularly in resource-limited settings.
- Implementing the SR-HCC score can potentially improve patient outcomes by preventing catastrophic ruptures.
Purpose:
Hepatocellular carcinoma (HCC) Spontaneous rupture (srHCC) is a life-threatening complication with a high mortality rate; however, no integrated predictive tool exists. This study aimed to develop and validate a novel nomogram (SR-HCC score) for srHCC risk prediction using a combination of clinical, radiological, and laboratory parameters.
Methods:
This retrospective cohort study included 186 HCC patients from The Third People's Hospital of Kunming (2010-2025), randomly split into training (80%) and validation (20%) sets. Covariates included demographic, tumor-related, and laboratory indices. Univariate and multivariate logistic regression analyses were used to identify independent predictors that were integrated into the nomogram. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves (discrimination) and calibration curves.
Results:
Key independent predictors of srHCC included tumor diameter (3-5 cm and 5-10 cm), number of tumors (2-3), capsular protrusion, Alpha-Fetoprotein (AFP) ≥100 ng/mL, moderate ΔALT (0-200 U/L, inverse association), and ΔAST >200 U/L. The nomogram achieved excellent discrimination (Area Under the Curve, AUC = 0.9617 in the training set; 0.9630 in the validation set) and good calibration, with predicted probabilities that closely matched the observed outcomes.
Conclusion:
SR-HCC score is a reliable and user-friendly tool for individualized srHCC risk stratification. This enables clinicians to prioritize preventive interventions and optimize surveillance, especially in resource-limited settings, ultimately improving patient outcomes by preventing catastrophic ruptures.
