背景：先前的研究试图为接受肝切除术的肝细胞癌（HCC）患者建立肝切除术后肝衰竭（PHLF）的预测模型。然而，多功能且有用的 PHLF 预测模型仍有待开发。因此，我们的目标是开发基于 IV 型胶原 7s 结构域（7s 胶原蛋白）的 HCC 患者 PHLF 的预测模型。方法：我们回顾性收集了2000年2月至2020年12月期间在我院接受初次根治性肝切除术的972例HCC患者的资料。使用限制三次样条进行多变量逻辑回归分析，以评估 7s 胶原蛋白对 PHLF 发生率的影响。基于 7s 胶原蛋白开发了列线图。结果：104 名患者 (11%) 确诊为 B 级或 C 级 PHLF：分别有 98 名 (10%) 和 6 名 (1%) PHLF B 级和 C 级。多变量逻辑回归分析显示，术前血清 7s 胶原水平与 PHLF 风险成比例增加显着相关，腹腔镜和开腹肝切除术均证实了这一点。基于 7s 胶原蛋白绘制列线图，一致性指数为 0.768。在预测模型中包含 7s 胶原蛋白值提高了预测准确性。结论：研究结果强调了 7s 胶原蛋白血清水平作为 PHLF 预测因素的有效性。我们使用 7s 胶原蛋白的新型列线图可能有助于预测 PHLF 的风险。

Background: Previous studies have attempted to establish predictive models for post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC) undergoing liver resection. However, a versatile and useful predictive model for PHLF remains to be developed. Therefore, we aimed to develop predictive models for PHLF based on type IV collagen 7s domain (7s collagen) in patients with HCC. Methods: We retrospectively collected data from 972 patients with HCC who had undergone initial curative liver resection between February 2000 and December 2020 at our hospital. Multivariate logistic regression analysis using a restricted cubic spline was performed to evaluate the effect of 7s collagen on the incidence of PHLF. A nomogram was developed based on 7s collagen. Results: PHLF grades B or C were identified in 104 patients (11%): 98 (10%) and 6 (1%) PHLF grades B and C, respectively. Multivariate logistic regression analysis revealed that the preoperative serum level of 7s collagen was significantly associated with a proportional increase in the risk of PHLF, which was confirmed in both laparoscopic and open liver resections. A nomogram was developed based on 7s collagen, with a concordance index of 0.768. The inclusion of 7s collagen values in the predictive model increased the predictive accuracy. Conclusion: The findings highlight the efficacy of the serum level of 7s collagen as a predictive factor for PHLF. Our novel nomogram using 7s collagen may be useful for predicting the risk of PHLF.