Correlation Between MELD Scores And Primary Hepatocellular Carcinoma With Cirrhosis

Objective:To explore the clinical value of MELD,Meld-NA and iMELD scores in predicting primary liver cancer with cirrhosis,and to compare these three scores,so as to provide convenient indicators for clinical screening of primary liver cancer.Methods:Clinical data of 157 patients with cirrhosis complicated with primary liver cancer and146 patients with cirrhosis admitted to the First Affiliated Hospital of Xinjiang Medical University from September 2018 to May 2022 were collected.At the same time,MELD,Meld-NA and iMELD scoring systems were used to evaluate the severity of liver cirrhosis and liver cancer,and the prediction value of the three scores for primary liver cancer with cirrhosis was compared.Results: 1.The levels of platelet,AST and ALB in patients with liver cirrhosis were significantly lower than those in patients with liver cirrhosis(P<0.05),the levels of ALT,GGT,AFP and TBIL,and the scores of MELD,Meld-NA and iMELD were significantly higher than those of cirrhosis group(P<0.05).2.Multivariate Logistic regression analysis showed that MELD score,iMELD score and AFP level were risk factors for liver cancer(P<0.05),MELD-NA was a protective factor for liver cancer(P<0.05).3.With the aggravation of liver disease,MELD,Meld-NA and iMELD scores were positively correlated with CTP grading(r=0.649,0.645,0.549,P all< 0.001),was negatively correlated with albumin(r=-0.431,-0.50,-0.459,P<0.001),PLT was negatively correlated with MELD and Meld-NA scores(r=-0.330,-0.265,P <0.05).AFP showed a negative correlation with MELD score(r=-0.324,P< 0.001).4.MELD(score<10 points,10 points ≤ score value<15 points),MELD-NA(score<10points,10 points ≤ score value<15 points),iMELD(25 points ≤ score<30 points)was positively correlated with liver cancer(r=0.462,0.227,0.469,0.249,0.228,P<0.05).5.Further ROC curve analysis showed MELD(AUC=0.874,95% CI:0.832～0.909),MELDNA(AUC=0.879,95%CI:0.836～0.913),iMELD(AUC=0.797,95%CI: 0.748～0.841)and joint score(AUC=0.880,95%CI:0.838-0.915)had the sensitivity of 78.98%,83.44%,70.70%,80.89%,and the specificity of 78.77%,77.40%,75.34%,80.82%,respectively.Conclusion: MELD,MELD-NA and iMELD scores have certain predictive value in liver cirrhosis complicated with primary liver cancer,and the combined detection of the three can improve the predictive efficacy of liver cirrhosis complicated with primary liver cancer.