Fujita Koji, Oura Kyoko, Yoneyama Hirohito, Shi Tingting, Takuma Kei, Nakahara Mai, Tadokoro Tomoko, Nomura Takako, Morishita Asahiro, Tsutsui Kunihiko, Himoto Takashi, Masaki Tsutomu
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki, Japan.
Department of Medical Technology, Kagawa Prefectural University of Health Sciences, Takamatsu, Japan.
Hepatol Res. 2019 Jul;49(7):731-742. doi: 10.1111/hepr.13333. Epub 2019 May 17.
Albumin-bilirubin (ALBI) grade was investigated to predict prognosis of patients with cirrhosis. It was defined using the ALBI score calculated based on serum total bilirubin and albumin, which represent liver function. The diagnostic accuracy for liver fibrosis staging in patients with chronic hepatitis using the ALBI score has not been investigated well. This study aimed to evaluate the diagnostic abilities of the ALBI score for liver fibrosis staging in chronic hepatitis and cirrhosis in Japanese patients with hepatitis C virus (HCV) infection.
Japanese patients with HCV infection who underwent liver biopsy examinations were enrolled in a retrospective study. Fibrosis staging and activity grading were assessed using the modified METAVIR score. The ALBI score was calculated according to the following equation: Log10 total bilirubin (μmol/L) × 0.66 + albumin (g/L) × (-0.085).
A total of 382 patients were enrolled in this study. The ALBI score differentiated fibrosis stage 4 from 3 and stage 3 from 2 (P < 0.05). When an ALBI score of -2.125 was adopted as a cut-off value, the sensitivity and specificity were 73.2% and 87.1%, respectively, with a positive likelihood ratio of 5.67 to differentiate stage 4 from stages 1-3. Kaplan-Meier analysis showed that smaller ALBI scores at baseline correlated with better hepatocellular carcinoma (HCC)-free and overall survival (P < 0.05).
The ALBI score indicates liver fibrosis staging in Japanese patients with HCV infection. Furthermore, smaller ALBI scores predict better HCC-free survival and overall survival. The ALBI score has the potential to expand its application from cirrhosis to chronic hepatitis.
研究白蛋白-胆红素（ALBI）分级对肝硬化患者预后的预测作用。它是根据代表肝功能的血清总胆红素和白蛋白计算出的ALBI评分来定义的。关于使用ALBI评分对慢性肝炎患者进行肝纤维化分期的诊断准确性尚未得到充分研究。本研究旨在评估ALBI评分对日本丙型肝炎病毒（HCV）感染患者慢性肝炎和肝硬化肝纤维化分期的诊断能力。
纳入接受肝活检检查的日本HCV感染患者进行回顾性研究。使用改良的METAVIR评分评估纤维化分期和活动度分级。ALBI评分根据以下公式计算：log10总胆红素（μmol/L）×0.66 + 白蛋白（g/L）×（-0.085）。
本研究共纳入382例患者。ALBI评分能够区分纤维化4期与3期以及3期与2期（P < 0.05）。当采用ALBI评分-2.125作为临界值时，区分4期与1 - 3期的敏感度和特异度分别为73.2%和87.1%，阳性似然比为5.67。Kaplan-Meier分析显示，基线时较低的ALBI评分与更好的无肝细胞癌（HCC）生存率和总生存率相关（P < 0.05）。
ALBI评分可用于评估日本HCV感染患者的肝纤维化分期。此外，较低的ALBI评分预示着更好的无HCC生存率和总生存率。ALBI评分有潜力将其应用范围从肝硬化扩展到慢性肝炎。
