School of Medicine, Nankai University, Tianjin, 300071, China.
Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Cardiovasc Intervent Radiol. 2021 Feb;44(2):261-270. doi: 10.1007/s00270-020-02637-9. Epub 2020 Oct 14.
To determine whether albumin-bilirubin (ALBI) grade could be used to predict the outcomes of patients with intrahepatic cholangiocarcinoma (ICC) who underwent ultrasound-guided percutaneous microwave ablation (MWA).
This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. We studied 52 treatment-naïve patients with 74 ICC lesions according to the Milan criteria who subsequently underwent MWA from April 2011 to March 2018. Overall survival (OS) and recurrence-free survival (RFS) were compared in groups classified by Child-Pugh score and ALBI grade, which were statistically analyzed with the log-rank test. Cox proportional hazard regression analyses were used to determine the prognostic factors for survival in patients with ICC.
The median follow-up time was 21.2 months (3.2-78.7 months). Seventeen patients died during this period. After MWA, the cumulative 1-, 3-, and 5-year OS rates were 87.4%, 51.4%, and 35.2%, respectively, and the cumulative 1-, 3-, and 5-year RFS rates were 68.9%, 56.9%, and 56.9%, respectively. The major complication rate was 3.8% (2/52). Stratified according to ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 95.5%, 72.4%, and 72.4% for patients with ALBI grade 1 and 62.5%, 40.6%, and 36.3% for patients with ALBI grade 2, respectively, showing a significant difference (P = 0.006). Multivariate analysis results showed that older age (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.11-2.82; P = 0.002), tumor size ≥ 3 cm in diameter (HR: 11.33, CI: 2.24-34.52; P = 0.021) and ALBI grade (HR: 8.23, CI: 1.58-58.00; P = 0.004) may be predictors of poor OS.
ALBI grade was validated as a significant biomarker for predicting survival in ICC patients within the Milan criteria who underwent MWA.
探讨白蛋白-胆红素（ALBI）分级能否预测米兰标准内接受超声引导经皮微波消融（MWA）治疗的肝内胆管癌（ICC）患者的结局。
本回顾性研究经机构审查委员会批准，豁免了知情同意书的要求。我们研究了 2011 年 4 月至 2018 年 3 月期间根据米兰标准接受 MWA 治疗的 52 例初治 ICC 患者的 74 个 ICC 病变。通过 Child-Pugh 评分和 ALBI 分级对患者进行分组，比较各组的总生存（OS）和无复发生存（RFS），采用对数秩检验进行统计学分析。采用 Cox 比例风险回归分析确定 ICC 患者生存的预后因素。
中位随访时间为 21.2 个月（3.2-78.7 个月）。在此期间，17 例患者死亡。MWA 后，1、3 和 5 年 OS 累积率分别为 87.4%、51.4%和 35.2%，1、3 和 5 年 RFS 累积率分别为 68.9%、56.9%和 56.9%。主要并发症发生率为 3.8%（2/52）。按 ALBI 分级分层，ALBI 分级 1 级患者 1、3 和 5 年 OS 累积率分别为 95.5%、72.4%和 72.4%，ALBI 分级 2 级患者分别为 62.5%、40.6%和 36.3%，差异有统计学意义（P=0.006）。多因素分析结果显示，年龄较大（HR：1.67，95%置信区间 [CI]：1.11-2.82；P=0.002）、肿瘤直径≥3cm（HR：11.33，CI：2.24-34.52；P=0.021）和 ALBI 分级（HR：8.23，CI：1.58-58.00；P=0.004）可能是 OS 不良的预测因素。
ALBI 分级可作为米兰标准内接受 MWA 治疗的 ICC 患者生存的重要生物标志物。
