Zou Heng, Yang Xin, Li Qing-Long, Zhou Qing-Xiang, Xiong Li, Wen Yu
Dig Dis. 2018;36(3):236-243. doi: 10.1159/000486590. Epub 2018 Mar 1.
BACKGROUND: The albumin-bilirubin (ALBI) grade is a newly proposed model for assessing the hepatic function. This study aimed to compare the value of the ALBI score with Child-Pugh score, model for end-stage liver disease (MELD) score and indocyanine green (ICG) R15 in predicting posthepatectomy liver failure (PHLF). METHODS: Patients undergoing curative resection for hepatocellular carcinoma (HCC) between January 2014 and June 2017 were enrolled. The values of the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were evaluated. RESULTS: A total of 473 HCC patients were enrolled. The ALBI score was identified as an independent predictor of PHLF. The AUCs for the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were 0.665, 0.649, 0.668, and 0.745 respectively. Multivariable analyses revealed that the ALBI score was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the Child-Pugh score and MELD score were not significant predictors of PHLF both in major and minor hepatectomy subgroups, and ICG R15 was only a significant predictor of PHLF in minor hepatectomy subgroup. CONCLUSION: The ALBI score showed superior predictive value of PHLF over Child-Pugh score, MELD score and ICG R15. We propose to use the ALBI score to evaluate surgical risk for HCC patients undergoing hepatic resection.
背景:白蛋白-胆红素(ALBI)分级是一种新提出的评估肝功能的模型。本研究旨在比较ALBI评分与Child-Pugh评分、终末期肝病模型(MELD)评分及吲哚菁绿(ICG)R15在预测肝切除术后肝衰竭(PHLF)方面的价值。 方法:纳入2014年1月至2017年6月期间接受肝细胞癌(HCC)根治性切除的患者。评估Child-Pugh评分、MELD评分、ICG R15和ALBI评分在预测PHLF方面的价值。 结果:共纳入473例HCC患者。ALBI评分被确定为PHLF的独立预测因素。Child-Pugh评分、MELD评分、ICG R15和ALBI评分预测PHLF的受试者工作特征曲线下面积(AUC)分别为0.665、0.649、0.668和0.745。多变量分析显示,无论肝切除亚组如何,ALBI评分都是PHLF的独立预测因素,但Child-Pugh评分和MELD评分在大肝切除和小肝切除亚组中均不是PHLF的显著预测因素,而ICG R15仅在小肝切除亚组中是PHLF的显著预测因素。 结论:ALBI评分在预测PHLF方面显示出比Child-Pugh评分、MELD评分和ICG R15更高的预测价值。我们建议使用ALBI评分来评估接受肝切除的HCC患者的手术风险。
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