确定白蛋白-胆红素分级（ALBI）对不可切除肝细胞癌患者行经动脉化疗栓塞术的预后价值。
To determine the prognostic value of the albumin-bilirubin grade (ALBI) in patients underwent transarterial chemoembolization for unresectable hepatocellular carcinoma.
作者信息
Khalid Muhammad Ali, Achakzai Inamullah Khan, Hanif Farina M, Ahmed Shoaib, Majid Zain, Luck Nasir Hassan
机构信息
Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, (SIUT), Karachi, Pakistan.
出版信息
Gastroenterol Hepatol Bed Bench. 2019 Spring;12(2):110-115.
AIM
We aimed at determining the prognostic value of the albumin-bilirubin grade (ALBI) in patients undergoing transarterial Chemoembolization for unresectable Hepatocellular carcinoma.
BACKGROUND
Various noninvasive liver reserve markers are used to predict the severity of liver injury. The role and probability of these markers in predicting the prognosis of patients with hepatocellular carcinoma (HCC) is still unknown.
METHODS
Patients who underwent TACE from 2013 to 2017 were included. Patient's age, gender, cause of cirrhosis, ALBI Grade along with the site, size and number of tumors were recorded. Radiological response to TACE was assessed by CT scan at 1 and 3 months after the procedure, respectively. Survival assessment was performed and all patients were assessed for survival until the last follow-up.
RESULTS
A total of 71 patients were included. Majority of them were male (80.3 %). The mean tumor size of 6 ± 3.9 cm. Majority of patients (54.9 %) had a single lesion and it was mostly localized to the right lobe (60.5 %). The most common cause of chronic liver disease was HCV (65.3%). Median Child class score (CTP) and MELD score were 7 and 10, respectively. Ascites was treated prior to TACE in 12 patients (16.9 %).Mean ALBI score in the study population was -1.59 ± 0.69, with the majority (49. 2 %) falling in grade 2. The mean duration of survival at the last follow up was of 12.1 ± 12.14 months (1- 49).Univariate analysis showed serum albumin (p = 0.003), serum bilirubin (p = 0.018), CTP score (p = 0.019), ALBI grade (p = 0.001) and presence of varices (p = 0.04) to be the main predictors of 6 months survival after TACE. On Cox analysis, only ALBI score (p = 0.038) showed statistical significant association.
CONCLUSION
ALBI grade may serve as a surrogate marker in predicting the prognosis of HCC patients undergoing Transarterial Chemoembolization.
目的
我们旨在确定白蛋白-胆红素分级（ALBI）在不可切除肝细胞癌经动脉化疗栓塞患者中的预后价值。
背景
多种非侵入性肝储备指标用于预测肝损伤的严重程度。这些指标在预测肝细胞癌（HCC）患者预后中的作用和可能性仍不明确。
方法
纳入2013年至2017年接受经动脉化疗栓塞（TACE）的患者。记录患者的年龄、性别、肝硬化病因、ALBI分级以及肿瘤的部位、大小和数量。分别在TACE术后1个月和3个月通过CT扫描评估对TACE的放射学反应。进行生存评估，对所有患者进行生存评估直至最后一次随访。
结果
共纳入71例患者。其中大多数为男性（80.3%）。平均肿瘤大小为6±3.9cm。大多数患者（54.9%）有单个病灶，且大多位于右叶（60.5%）。慢性肝病最常见的病因是丙型肝炎病毒（HCV，65.3%）。Child分级评分（CTP）中位数和终末期肝病模型（MELD）评分分别为7分和10分。12例患者（16.9%）在TACE术前接受了腹水治疗。研究人群的平均ALBI评分为-1.59±0.69，大多数（49.2%）为2级。最后一次随访时的平均生存时间为12.1±12.14个月（1 - 49个月）。单因素分析显示血清白蛋白（p = 0.003）、血清胆红素（p = 0.018）、CTP评分（p = 0.019）、ALBI分级（p = 0.001）和静脉曲张的存在（p = 0.04）是TACE术后6个月生存的主要预测因素。在Cox分析中，只有ALBI评分（p = 0.038）显示出统计学显著关联。
结论
ALBI分级可作为预测接受经动脉化疗栓塞的HCC患者预后的替代指标。
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