摘要
目的探讨清蛋白/总胆红素比值(ABR)对于行肝切除手术治疗的肝细胞癌患者生存预后的预测效能。方法回顾性分析2012年1月至2020年12月聊城市人民医院行肝切除手术治疗的肝细胞癌患者的临床资料,收集患者围术期检测指标,使用单因素及多因素COX分析两种基于清蛋白、总胆红素的肝功能评价指标,即清蛋白-胆红素(ALBI)评分和ABR,以及其他临床特征对于肝细胞癌患者术后生存预后的影响。绘制ABR和ALBI评分用于预测肝细胞癌患者肝切除术后1年和5年内发生死亡的受试者工作特征(ROC)曲线。使用Kaplan-Meier法进行预后分析,分析ABR在肝细胞癌患者肝切除术后总体生存和无复发生存评估中的价值。结果该研究共纳入652例肝细胞癌患者。单因素及多因素COX分析发现TNM分期、肿瘤分化程度、手术方式、肿瘤最大径、甲胎蛋白水平、术后凝血酶原国际标准化比值及术后ABR是行肝切除术的肝细胞癌患者预后的独立影响因素(P<0.05)。预后分析显示,ABR高值组患者中位生存时间为(58.42±1.81)个月,中位无复发生存时间为(43.29±1.72)个月;而低值组患者中位生存时间为(39.23±2.49)个月,中位无复发生存时间为(35.06±2.71)个月。ABR高值组患者生存预后优于ABR低值组(P<0.05),而且术后ABR的预后评估效能不受甲胎蛋白水平的影响。结论术后ABR可作为一种新的行肝切除术肝细胞癌患者预后评估的简易指标,术后ABR高值患者的预后更好。
Objective To investigate the prognostic value of albumin/total bilirubin ratio(ABR)in patients with hepatocellular carcinoma after hepatectomy.Methods The clinical data of patients with hepatocellular carcinoma who underwent hepatectomy in Liaocheng People′s Hospital from January 2012 to December 2020 were retrospectively analyzed.The results of perioperative tests of patients were collected.Univariate and multivariate COX analysis were used to analyze two liver function evaluation indicators based on albumin and total bilirubin,including albumin-bilirubin(ALBI)score and ABR,and the influence of other clinical characteristics on the survival and prognosis of patients with hepatocellular carcinoma after surgery.The receiver operating characteristic(ROC)curves of ABR and ALBI score for predicting death within 1 year and 5 years after hepatectomy were plotted.Kaplan-Meier method was used to analyze the value of ABR on the evaluation of overall survival and recurrence-free survival of hepatocellular carcinoma patients after hepatectomy.Results A total of 652 patients with hepatocellular carcinoma were enrolled in the study.Univariate and multivariate COX analysis showed that TNM stage,degree of tumor differentiation,surgical approach,maximum tumor diameter,alpha-fetoprotein level,postoperative prothrombin international normalized ratio and postoperative ABR were independent prognostic factors for hepatocellular carcinoma patients who underwent hepatectomy(P<0.05).Prognostic analysis showed that the median survival time of patients in the high-ABR group was(58.42±1.81)months,and the median recurrence-free survival time was(43.29±1.72)months.The median overall survival and recurrence-free survival in the low-ABR group were(39.23±2.49)months and(35.06±2.71)months,respectively.The survival prognosis of patients in the high-ABR group was better than that in the low-ABR group(P<0.05),and the prognostic evaluation efficacy of ABR after operation was not affected by alpha-fetoprotein level.Conclusion Postoperative ABR could be used as a new simple prognostic indicator for hepatocellular carcinoma patients after hepatectomy.Patients with high postoperative ABR have better prognosis.
作者
孙爱霞
徐攀
李轲
曲凯
姜博
SUN Aixia;XU Pan;LI Ke;QU Kai;JIANG Bo(Department of Clinical Laboratory,Liaocheng People′s Hospital,Liaocheng,Shandong 252000,China;Department of Central Laboratory,Liaocheng People′s Hospital,Liaocheng,Shandong 252000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China)
出处
《国际检验医学杂志》
CAS
2023年第14期1681-1686,共6页
International Journal of Laboratory Medicine
基金
陕西省自然科学基金项目(2020JM-373)。
关键词
清蛋白/总胆红素比值
肝切除术
肝细胞癌
预后
albumin/total bilirubin ratio
hepatectomy
hepatocellular carcinoma
prognosis
作者简介
孙爱霞,女,副主任技师,主要从事临床检验及肿瘤相关筛查研究;通信作者:姜博,E-mail:dawj@126.com。
