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阿尔比评分作为肝细胞癌切除术后代偿期肝硬化患者生存的预测指标:与帕尔比和终末期肝病模型肝功能评分相关的探索性评估

Albi Score as a Predictor of Survival in Patients with Compensated Cirrhosis Resected for Hepatocellular Carcinoma: Exploratory Evaluation in Relationship to Palbi and Meld Liver Function Scores.

作者信息

Božin Tonći, Mustapić Sanda, Bokun Tomislav, Patrlj Leonardo, Rakić Mislav, Aralica Gorana, Kujundžić Milan, Trkulja Vladimir, Grgurević Ivica

机构信息

Department of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia.

Department of Abdominal Surgery, Dubrava University Hospital, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2018 Jun;57(2):292-300. doi: 10.20471/acc.2018.57.02.09.

Abstract

The aim of the study was to explore predictive value of the ALBI, PALBI and MELD scores on survival in patients resected for hepatocellular carcinoma with compensated liver cirrhosis and no macrovascular infiltration. In this retrospective study, longitudinal survival analysis was performed. We analyzed patient/tumor characteristics and MELD, ALBI and PALBI scores as liver function tests for predicting survival outcome. Survival was analyzed from the date of liver resection until death, liver transplantation, or end of follow-up. Patients were stratified for age, cirrhosis etiology, presence of esophageal varices, hepatocellular carcinoma stage, microvascular invasion, histologic differentiation, and resection margins. We identified 38 patients (alcoholic cirrhosis in 84.2% of patients) resected over an 8-year period. Median preoperative MELD score was 8, ALBI score -2.63, and PALBI score -2.38. During the follow-up period, 24 patients died. Estimated median survival time was 36 months. Microvascular invasion was observed in 33 patients. Higher ALBI score was associated with 23.1% higher relative risk of death. PALBI score was associated with 12.1% higher relative risk of death, whereas MELD score was not associated with the risk of death. In conclusion, ALBI score demonstrated significant predictive capabilities for survival in patients with compensated cirrhosis resected for hepatocellular carcinoma.

摘要

本研究的目的是探讨ALBI、PALBI和MELD评分对代偿期肝硬化且无大血管侵犯的肝细胞癌切除患者生存情况的预测价值。在这项回顾性研究中,进行了纵向生存分析。我们分析了患者/肿瘤特征以及作为肝功能检查的MELD、ALBI和PALBI评分,以预测生存结果。从肝切除日期至死亡、肝移植或随访结束分析生存情况。根据年龄、肝硬化病因、食管静脉曲张的存在、肝细胞癌分期、微血管侵犯、组织学分化和手术切缘对患者进行分层。我们确定了在8年期间接受手术的38例患者(84.2%的患者为酒精性肝硬化)。术前MELD评分中位数为8,ALBI评分为-2.63,PALBI评分为-2.38。在随访期间,24例患者死亡。估计中位生存时间为36个月。33例患者观察到微血管侵犯。较高的ALBI评分与死亡相对风险高23.1%相关。PALBI评分与死亡相对风险高12.1%相关,而MELD评分与死亡风险无关。总之,ALBI评分对代偿期肝硬化肝细胞癌切除患者的生存情况具有显著的预测能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3055/6531997/37edb391fbaf/acc-57-292-f1.jpg

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