Pang Qing, Zhang Jing-Yao, Xu Xin-Sen, Song Si-Dong, Chen Wei, Zhou Yan-Yan, Miao Run-Chen, Qu Kai, Liu Su-Shun, Dong Ya-Feng, Liu Chang
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University College of Medicine , Xi'an, Shaanxi Province , China.
Scand J Clin Lab Invest. 2015 Jan;75(1):73-84. doi: 10.3109/00365513.2014.981759. Epub 2014 Dec 3.
Hepatocellular carcinogenesis is associated with the progression of cirrhosis, and the latter further aggravates tumor development and prognosis. The aim of the study was to investigate the prognostic values of 12 cirrhosis-relative noninvasive models in hepatocellular carcinoma (HCC).
We retrospectively analyzed 363 HCC patients who either underwent partial hepatectomy (PH) or received transcatheter arterial chemoembolization (TCAE). Preoperative data were collected to calculate these indices using the original formulas. Diagnostic accuracy of these models in detection of cirrhosis was evaluated by area under receiver operating characteristic curve (AUC) analysis. Multivariate analyses were performed to assess the independent prognostic significance of the 12 indicators.
Aspartate aminotransferase-platelet ratio index (APRI) and Goteborg University Cirrhosis Index (GUCI) were found to be significant in discriminating cirrhotic patients from non-cirrhotic individuals. When the indices were expressed as continuous variables, multivariate analyses indicated that APRI and GUCI were independent indices to predict overall survival in patients underwent PH, with a hazard ratio (HR) value 1.04 (p = 0.005) and 1.07 (p = 0.001), respectively. In the cohort of TACE, APRI and GUCI were independently associated with survival as well.
Of the 12 indices, APRI and GUCI were relatively accurate predictors of cirrhosis status as well as outcome of HCC. As only a limited study population was enrolled in the current study, larger cohorts are needed to validate our results.
肝细胞癌的发生与肝硬化的进展相关,而肝硬化会进一步加重肿瘤的发展及预后。本研究旨在探讨12种与肝硬化相关的非侵入性模型在肝细胞癌(HCC)中的预后价值。
我们回顾性分析了363例接受部分肝切除术(PH)或经动脉化疗栓塞术(TCAE)的HCC患者。收集术前数据,使用原始公式计算这些指标。通过受试者工作特征曲线(AUC)分析评估这些模型在检测肝硬化方面的诊断准确性。进行多因素分析以评估这12项指标的独立预后意义。
天冬氨酸转氨酶-血小板比值指数(APRI)和哥德堡大学肝硬化指数(GUCI)在区分肝硬化患者和非肝硬化个体方面具有显著意义。当将这些指标表示为连续变量时,多因素分析表明,APRI和GUCI是预测接受PH患者总生存期的独立指标,风险比(HR)值分别为1.04(p = 0.005)和1.07(p = 0.001)。在TACE队列中,APRI和GUCI也与生存期独立相关。
在这12项指标中,APRI和GUCI是肝硬化状态以及HCC预后相对准确的预测指标。由于本研究纳入的研究人群有限,需要更大的队列来验证我们的结果。