临床肝胆病杂志2018，Vol.34Issue(2)：292-297,6.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
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
摘要
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 78.1％ and a specificity of 55.8％ in predicting PHLF at the optimal cut-off value of-2.77,and the 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.关键词
癌,肝细胞/肝切除术/肝功能衰竭/危险因素Key words
carcinoma, hepatocellular/hepatectomy/liver failure/risk factors分类
医药卫生引用本文复制引用
麦荣云,黎乐群,叶甲舟,王言焱,白涛,陈洁,黄山,邬国斌,吴飞翔,赵荫农..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[J].临床肝胆病杂志,2018,34(2):292-297,6.基金项目
国家自然科学基金(81360315) （81360315）
广西卫生与计划生育委员会适宜推广技术项目(S201629) （S201629）
