ALBI联合APRI对HBV相关肝细胞癌肝切除术后肝衰竭发生的预测价值

麦荣云; 叶甲舟; 王言焱; 白涛; 陈洁; 黄山; 邬国斌; 吴飞翔; 赵荫农; 黎乐群

doi:10.3969/j.issn.1001-5256.2018.02.015

ALBI联合APRI对HBV相关肝细胞癌肝切除术后肝衰竭发生的预测价值

DOI: 10.3969/j.issn.1001-5256.2018.02.015

广西医科大学附属肿瘤医院肝胆外科

基金项目:

国家自然科学基金(81360315)；广西卫生与计划生育委员会适宜推广技术项目(S201629)；

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中图分类号: R735.7
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出版历程
- 出版日期: 2018-02-20

Value of albumin-bilirubin score combined with aspartate aminotransferase-to-platelet ratio index in predicting the development of posthepatectomy liver failure in patients with HBV-related hepatocellular carcinoma

Department of Hepatobiliary Surgery, The Affiliated Tumor Hospital of Guangxi Medical University

Research funding:

摘要

摘要:
目的探讨血清白蛋白-胆红素评分（ALBI）联合天冬氨酸转氨酶-血小板比值（APRI）预测HBV相关肝细胞癌（HCC）肝切除术后发生肝衰竭（PHLF）的作用。方法回顾性研究广西医科大学附属肿瘤医院2006年1月-2013年10月接受肝切除术治疗的HBV相关HCC患者,将Child-Pugh评分作为对照,评估术前ALBI、APRI、ALBI联合APRI评分预测PHLF的作用。计数资料采用χ2或Fisher确切检验,采用logistic回归模型进行多变量分析识别PHLF的独立预测指标。结果纳入本研究的1055例患者中,共有151例（14.3%）发生PHLF。单、多因素分析显示,ALBI、APRI与PHLF的患者预后有显著相关性（P值均<0.001）。ALBI和APRI的受试者工作特征曲线下面积（AUC）均显著高于Child-Pugh评分（P值均<0.001）。albi的最佳截断值为-2.77时预测phlf的灵敏度与特异度分别为78.1%、55.8%,albi>-2.77时PHLF及PHLF A/B/C的发病率明显高于该评分≤-2.77时的情况（P值均<0.001）;A...
- 癌,肝细胞 /
- 肝切除术 /
- 肝功能衰竭 /
- 危险因素
Abstract:
Objective To investigate the value of albumin-bilirubin (ALBI) score combined with aspartate aminotransferase-to-platelet ratio index (APRI) in predicting the development of posthepatectomy liver failure (PHLF) in patients with HBV-related hepatocellular carcinoma (HCC) .Methods A retrospective analysis was performed for the patients with HBV-related HCC who underwent hepatectomy in The Affiliated Tumor Hospital of Guangxi Medical University from January 2006 to October 2013.With Child-Pugh score as control, the values of ALBI, APRI, and ALBI combined with APRI in predicting PHLF were analyzed.The chi-square test or the Fisher exact test was used for comparison of categorical data between groups, and the logistic regression model was used to identify independent predictive indices for PHLF.Results A total of 1055 patients were enrolled in this study, among whom 151 (14.3%) experienced PHLF.The univariate and multivariate analyses showed that ALBI and APRI were significantly associated with the prognosis of PHLF patients (P < 0.001) .ALBI and APRI had a significantly higher area under the receiver operating characteristic curve (AUC) than Child-Pugh score (both P<0.001) .albi="" had="" a="" sensitivity="" of="" and="" specificity="" in="" predicting="" phlf="" at="" the="" optimal="" cut-off="" value="" patients="" with="" albi="">-2.77 had a significantly higher incidence rate of PHLF A/B/C than those with ALBI ≤-2.77 (P < 0.001) .APRI had a sensitivity of 61.6% and a specificity of 71.0% in predicting PHLF at the optimal cut-off value of 0.85, and the patients with APRI >0.85 had a significantly higher incidence rate of PHLF A/B/C than those with APRI ≤0.85 (P < 0.001) .The combination of ALBI and APRI had a significantly higher AUC than ALBI or APRI (P < 0.001 and P = 0.047) .The combination of ALBI and APRI had a sensitivity of 78.1% and a specificity of 62.2% in predicting PHLF at the optimal cut-off value of-13.10, and the patients with the combination of ALBI and APRI >-13.10 had a significantly higher incidence rate of PHLF A/B/C than those with the combination of ALBI and APRI ≤-13.10 (P < 0.001) .Conclusion ALBI combined with APRI can be used as a new, convenient, and reliable index for predicting PHLF.
- carcinoma, hepatocellular /
- hepatectomy /
- liver failure /
- risk factors

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