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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 11
Nov.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(11): 2575-2583

Value of albumin-bilirubin grade in predicting liver function changes and prognosis of hepatocellular carcinoma patients undergoing transarterial chemoembolization: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2021.11.018
  • 1.

    Graduate School, North China University of Science and Technology, Tangshan, Hebei 063210, China

  • 2.

    Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang 050051, China

  • Received Date: 2021-03-29
  • Accepted Date: 2021-04-20
  • Published Date: 2021-11-20
    Abstract
  •   Objective  To investigate the value of albumin-bilirubin (ALBI) grade in evaluating liver function changes and prognosis of hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).  Methods  PubMed, the Cochrane Library, EMbase, Web of Science, OVID, CNKI, Wanfang Data, VIP, and CBM databases were searched for studies on ALBI grade for evaluating liver function changes and prognosis of HCC patients undergoing TACE published up to December 2020. After quality assessment and data extraction, RevMan 5.3 was used to perform a meta-analysis of the studies included. The chi-square test was used to evaluate heterogeneity between studies; hazard ratio (HR)/odds ratio (OR) and corresponding 95% confidence interval (CI) were used to evaluate outcome measures; funnel plots were used to assess publication bias.  Results  A total of 18 articles were included, with 9940 patients in total. The meta-analysis showed that the HCC patients with higher ALBI grades after TACE had a shorter overall survival time than those with lower ALBI grades (2nd vs 1st: HR=1.48, 95%CI: 1.39-1.57, P < 0.000 01; 3rd vs 1st: HR=2.45, 95%CI: 1.92-3.13, P < 0.000 01; 3rd vs 2nd: HR=1.91, 95%CI: 1.71-2.13, P < 0.000 01). The degree of deterioration of ALBI caused by 2 times of TACE was higher than that caused by 1 time of TACE (OR=1.91, 95%CI: 1.27-2.88, P < 0.05); the degree of deterioration of ALBI caused by 3 times of TACE was higher than that caused by 1 time of TACE (OR=3.21, 95%CI: 1.95-5.28, P < 0.05); the degree of deterioration of ALBI caused by 3 times of TACE was higher than that caused by 2 times of TACE (OR=1.70, 95%CI: 1.07-2.70, P < 0.05). In addition, ALBI grade could predict the onset of acute-on-chronic liver failure (ACLF) after TACE (OR=4.57, 95%CI: 2.76-7.57, P < 0.000 01).  Conclusion  Repeated TACE treatment can cause continuous deterioration of liver function based on ALBI, and ALBI has an important clinical value in predicting prognosis and the risk of ACLF after TACE.

     

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