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, 753 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. The nomogram showed a good performance in prognosis prediction of HCC.