Shimizu Takayuki, Ishizuka Mitsuru, Suzuki Takashi, Tanaka Genki, Park Kyung Hwa, Matsumoto Takatsugu, Shiraki Takayuki, Sakuraoka Yuhki, Kato Masato, Aoki Taku, Kubota Keiichi
Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan.
J Surg Oncol. 2017 Dec;116(8):1166-1175. doi: 10.1002/jso.24772. Epub 2017 Aug 29.
Although the globulin-to-albumin ratio (GAR) is useful for prognostication of patients with various cancers, its relationship with hepatocellular carcinoma (HCC) remains unclear. The study aims to investigate the relationship between GAR and postoperative survival among patients with HCC undergoing potentially curative liver resection (LR).
We retrospectively reviewed 368 patients with newly diagnosed HCC who underwent initial and potentially curative LR. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS). Kaplan-Meier analysis and log-rank test were used to compare OS and disease-free survival (DFS).
The result of multivariate analysis using 25 clinical characteristics selected by univariate analysis revealed that the GAR (≥0.918/<0.918) was significantly associated with OS (hazard ratio [HR], 2.398; 95% confidence interval [CI], 1.012-5.683; P = 0.047), as well as platelet count (<14/≥14, ×10 /mm ) and portal vein invasion (presence/absence). Kaplan-Meier analysis and log-rank test demonstrated that the OS and DFS of patients with a high GAR (>0.918) were significantly worse than that of patients with a low GAR (≤0.918).
The GAR is a useful predictor of postoperative survival among patients with HCC undergoing potentially curative LR.
尽管球蛋白与白蛋白比值（GAR）对多种癌症患者的预后评估有帮助，但其与肝细胞癌（HCC）的关系仍不明确。本研究旨在探讨GAR与接受潜在根治性肝切除术（LR）的HCC患者术后生存之间的关系。
我们回顾性分析了368例新诊断为HCC并接受初次潜在根治性LR的患者。采用Cox比例风险模型进行单因素和多因素分析，以检测与总生存（OS）相关的临床特征。采用Kaplan-Meier分析和对数秩检验比较OS和无病生存（DFS）。
对单因素分析筛选出的25个临床特征进行多因素分析的结果显示，GAR（≥0.918/<0.918）与OS显著相关（风险比[HR]，2.398；95%置信区间[CI]，1.012 - 5.683；P = 0.047），血小板计数（<14/≥14，×10⁹/mm³）和门静脉侵犯（存在/不存在）也与之相关。Kaplan-Meier分析和对数秩检验表明，GAR高（>0.918）的患者的OS和DFS显著低于GAR低（≤0.918）的患者。
GAR是接受潜在根治性LR的HCC患者术后生存的有用预测指标。
