Construction of an interpretable model for predicting survival outcomes in patients with middle to advanced hepatocellular carcinoma (≥5 cm) using lasso-cox regression

作者：Han Li, Bo Yang, Chenjie Wang, Bo Li, Lei Han, Yi Jiang, Yanqiong Song, Lianbin Wen, Mingyue Rao, Jianwen Zhang, Xueting Li, Kun He, Yunwei Han · 发表于：Frontiers in Pharmacology · 年份：2024 · DOI：10.3389/fphar.2024.1452201 · 被引用次数：4 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Inflammatory Biomarkers in Disease Prognosis、Ferroptosis and cancer prognosis

Background: In this retrospective study, we aimed to identify key risk factors and establish an interpretable model for HCC with a diameter ≥ 5 cm using Lasso regression for effective risk stratification and clinical decision-making. Methods: In this study, 843 patients with advanced hepatocellular carcinoma (HCC) and tumor diameter ≥ 5 cm were included. Using Lasso regression to screen multiple characteristic variables, cox proportional hazard regression and random survival forest models (RSF) were established. By comparing the area under the curve (AUC), the optimal model was selected. The model was visualized, and the order of interpretable importance was determined. Finally, risk stratification was established to identify patients at high risk. Result: Lasso regression identified 8 factors as characteristic risk factors. Subsequent analysis revealed that the lasso-cox model had AUC values of 0.773, 0.758, and 0.799, while the lasso-RSF model had AUC values of 0.734, 0.695, and 0.741, respectively. Based on these results, the lasso-cox model was chosen as the superior model. Interpretability assessments using SHAP values indicated that the most significant characteristic risk factors, in descending order of importance, were tumor number, BCLC stage, alkaline phosphatase (ALP), ascites, albumin (ALB), and aspartate aminotransferase (AST). Additionally, through risk score stratification and subgroup analysis, it was observed that the median OS of the low-risk group was signi...