白蛋白-胆红素评分预测肝癌患者肝切除术后肝功能衰竭的效果。

Effectiveness of Albumin-bilirubin Score as a Predictor of Post-hepatectomy Liver Failure in Patients with Hepatocellular Carcinoma.

机构信息

Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.

Chang Kee-Ryo Memorial Liver Institute, Kosin University College of Medicine, Busan, Korea.

出版信息

Korean J Gastroenterol. 2021 Mar 25;77(3):115-122. doi: 10.4166/kjg.2020.148.

DOI:10.4166/kjg.2020.148

PMID:33658474

Abstract

BACKGROUNDS/AIMS: Post-hepatectomy liver failure (PHLF) is a major concern for patients with hepatocellular carcinoma (HCC) who have undergone liver resection. The albumin-bilirubin (ALBI) score is a novel model for assessing liver function. We aimed to investigate the effectiveness of the ALBI score as a predictor of PHLF in HCC patients who have undergone hepatectomy in South Korea.

METHODS

Between January 2014 and November 2018, HCC patients who underwent hepatectomy and indocyanine retention rate at 15 min (ICG-R15) test were enrolled in this study.

RESULTS

A total of 101 patients diagnosed with HCC underwent hepatectomy. Thirty-two patients (31.7%) experienced PHLF. The ALBI score (OR 2.83; 95% CI 1.22-6.55; p=0.015), ICG-R15 (OR 1.07; 95% CI 1.02-1.12; p=0.007) and ALBI grade (OR 2,86; 95% CI 1.08-7.58; p=0.035) were identified as independent predictors of PHLF by multivariable analysis. The area under the receiver operating characteristic curve of the ALBI score and ICG-R15 were 0.676 (95% CI 0.566-0.785) and 0.632 (95% CI 0.513-0.752), respectively. The optimal cutoff value of the ALBI score in predicting PHLF was -2.62, with a sensitivity of 75.0% and a specificity of 56.5%.

CONCLUSIONS

The ALBI score is an effective predictor of PHLF in patients with HCC, and its predictive ability is comparable to that of ICG-R15.

摘要

背景/目的：肝癌患者行肝切除术后发生肝衰竭（PHLF）是一个主要关注点。白蛋白-胆红素（ALBI）评分是一种新的肝功能评估模型。我们旨在研究 ALBI 评分作为韩国行肝切除术的肝癌患者 PHLF 预测因子的有效性。

方法

2014 年 1 月至 2018 年 11 月，我们纳入了接受肝切除术和吲哚菁绿 15 分钟滞留率（ICG-R15）检测的 HCC 患者。

结果

共有 101 例 HCC 患者接受了肝切除术，其中 32 例（31.7%）发生了 PHLF。多变量分析显示，ALBI 评分（OR 2.83；95%CI 1.22-6.55；p=0.015）、ICG-R15（OR 1.07；95%CI 1.02-1.12；p=0.007）和 ALBI 分级（OR 2.86；95%CI 1.08-7.58；p=0.035）是 PHLF 的独立预测因子。ALBI 评分和 ICG-R15 的受试者工作特征曲线下面积分别为 0.676（95%CI 0.566-0.785）和 0.632（95%CI 0.513-0.752）。预测 PHLF 的 ALBI 评分最佳截断值为-2.62，敏感性为 75.0%，特异性为 56.5%。