Abstract
Objective
The Chitinase 3-like protein 1 (CHI3L1) is currently used as a biomarker for the diagnosis of liver fibrosis. However, its prognostic value for hepatocellular carcinoma (HCC) patients remains controversial. In this study, we aimed to investigate the prognostic value of the CHI3L1 in HCC patients after hepatectomy.
Methods
In total, 754 HCC patients who underwent curative hepatectomy between January 2017 to August 2021 were retrospectively recruited. The probability of overall survival (OS) was evaluated by the Kaplan-Meier method and compared between groups using the log-rank test. Cox proportional hazard regression analysis was used to determine the independent prognostic factors. A prognostic nomogram was constructed for further examine the clinical utility of CHI3L1 in HCC.
Results
Kaplan-Meier analysis revealed that elevated serum CHI3L1 levels were associated with worse overall survival of HCC patients. Multivariate Cox regression analysis showed that the high-CHI3L1 group (≥198.94 ng/ml) was associated with a shorter survival time compared with that in the low-CHI3L1 group (< 198.94 ng/ml) after adjustment for potential confounding factors (HR =1.43, 95% CI = 1.05-1.94, P = 0.024). Additionally, the nomogram had sufficient calibration and discriminatory power in the training cohort, with C-indexes of 0.723 (95% CI: 0.673-0.772). The validation cohort showed similar results. Finally, we demonstrated that the AUC of the nomogram was 0.752 (95% CI: 0.683-0.821), which had better predictive ability than AFP (AUC: 0.644, 95% CI: 0.577-0.711).
Conclusion
Our results confirmed that the CHI3L1 could serve as an independent predictor for OS in HCC patients after hepatectomy, thus helping clinicians to develop individualized treatment and follow-up plans for the HCC patients. Further confirmation is needed due to the study limitations.