Department of Hepatobiliary Surgery, Fuling Central Hospital, Chongqing, 408000, China.
Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
Asia Pac J Clin Oncol. 2021 Oct;17(5):e238-e248. doi: 10.1111/ajco.13458. Epub 2020 Oct 30.
An elevated preoperative aspartate aminotransferase-to-lymphocyte ratio index (ALRI) may predict poor survival in various cancers. However, the prognostic value of aminotransferase-to-lymphocyte ratio index (ALRI) in patients with hepatocellular carcinoma (HCC) remains to be determined.
A retrospective cohort study was conducted among 983 patients with HCC in our hospital from February 2007 to March 2016. A propensity-score matching (PSM) was performed to correct the selection bias and confounding factors. The risk of death and recurrence was plotted over aminotransferase-to-lymphocyte ratio index (ALRI) using the locally weighted scatterplot smoothing (LOWESS)-smoothed fit curve. Time-dependent receiver operating characteristic (ROC) and Kaplan-Meier method analysis was utilized to the role of aminotransferase-to-lymphocyte ratio index (ALRI) in HCC. Multivariate analysis was conducted to identify independent prognostic factors associated with overall survival (OS) and recurrence-free survival (RFS).
With the increase of aminotransferase-to-lymphocyte ratio index (ALRI), the risk of recurrence and death in HCC patients increases. In time-dependent ROC analysis, the AUC of aminotransferase-to-lymphocyte ratio index (ALRI) for predicting 1-, 3- and 5-year OS were 0.668 (95% CI: 0.596-0.740), 0.605 (95% CI: 0.560-0.649) and 0.613 (95% CI: 0.570-0.656), respective. The AUC of aminotransferase-to-lymphocyte ratio index (ALRI) for predicting 1-, 3- and 5-year RFS were 0.598 (95% CI: 0.555-0.641), 0.590 (95% CI: 0.552-0.628) and 0.604 (95% CI: 0.562-0.646), respectively. HCC patients with high aminotransferase-to-lymphocyte ratio index (ALRI) had a poor overall survival. Moreover, cox regression analysis revealed that aminotransferase-to-lymphocyte ratio index (ALRI) was an independent factor affecting the prognosis of HCC patients.
Elevated preoperative aminotransferase-to-lymphocyte ratio index (ALRI) is a noninvasive, simple, and effective predictor in the prognosis of patients with HCC.
天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）升高可能预示着多种癌症的生存不良。然而，天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）在肝细胞癌（HCC）患者中的预后价值仍有待确定。
对 2007 年 2 月至 2016 年 3 月我院 983 例 HCC 患者进行回顾性队列研究。采用倾向评分匹配（PSM）校正选择偏倚和混杂因素。使用局部加权散点平滑（LOWESS）拟合曲线对天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）进行死亡和复发风险绘图。采用时间依赖性接收器工作特征（ROC）和 Kaplan-Meier 方法分析天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）在 HCC 中的作用。采用多变量分析确定与总生存期（OS）和无复发生存期（RFS）相关的独立预后因素。
随着天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）的升高，HCC 患者的复发和死亡风险增加。在时间依赖性 ROC 分析中，天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）预测 1、3 和 5 年 OS 的 AUC 分别为 0.668（95%CI：0.596-0.740）、0.605（95%CI：0.560-0.649）和 0.613（95%CI：0.570-0.656）。天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）预测 1、3 和 5 年 RFS 的 AUC 分别为 0.598（95%CI：0.555-0.641）、0.590（95%CI：0.552-0.628）和 0.604（95%CI：0.562-0.646）。HCC 患者的天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）较高，其总体生存较差。此外，cox 回归分析表明，天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）是影响 HCC 患者预后的独立因素。
术前天门冬氨酸转氨酶与淋巴细胞比值指数（ALRI）升高是预测 HCC 患者预后的一种非侵入性、简单、有效的指标。
