Construction of a Nomogram Integrating Magnetic Resonance Imaging Features and Ephrin-A3 Expression to Predict Postoperative Overall Survival in Hepatocellular Carcinoma

Purpose

Elevated EFNA3 mRNA is associated with poor prognosis in hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic value of Ephrin-A3 immunohistochemical expression and construct a nomogram combining MRI features and Ephrin-A3 expression for postoperative OS prediction in HCC. Patients and Methods: We conducted a retrospective analysis of 111 HCC patients, from whom MRI data were collected, and Ephrin-A3 immunohistochemistry was performed. Using an optimal cut-off value of averaged optical density (AOD) derived from Ephrin-A3 staining to predict OS, patients were categorized into high and low expression groups. The cohort was randomly split into training (70%) and validation (30%) sets. Univariate and multivariate Cox regression analyses identified independent OS predictors, and a nomogram was constructed to predict post-surgical OS. We assessed the model’s performance through receiver operating characteristic (ROC) curves, area under the curve (AUC) measurements, Kaplan–Meier survival curves, calibration curves, and decision curve analysis (DCA) in both datasets.