MELD-Sarcopenia 优于 ALBI 和 MELD 评分在等待肝移植的肝细胞癌患者。
MELD-Sarcopenia is Better than ALBI and MELD Score in Patients with Hepatocellular Carcinoma Awaiting Liver Transplantation.
机构信息
Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Egypt.
Department of Anesthesia, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.
出版信息
Asian Pac J Cancer Prev. 2021 Jul 1;22(7):2005-2009. doi: 10.31557/APJCP.2021.22.7.2005.
BACKGROUND
The albumin bilirubin (ALBI) score and model of end stage liver disease (MELD) are prognostic in patients with hepatocellular carcinoma (HCC). Aim was to compare MELD-sarcopenia to MELD and ALBI scores in patients with HCC awaiting liver transplantation.
METHODS
patients with HCC (n=262) were included and followed up for 12 months. Baseline MELD, ALBI and MELD-sarcopenia models were calculated.
RESULTS
The average age was 59.61 ±8.09 years. Most patients were males (69.5%), CTP class A (55.7%) and BCLC stage B (54.2%). Hepatitis C virus was the main cause of liver cirrhosis in most patients (88.9%). The average MELD, MELD-sarcopenia and median ALBI score were 10.65 ±2.54, 15.11 ±6.22 and -2.12 (0.74) respectively. Sarcopenia patients had higher MELD, ALBI and MELD-sarcopenia values. Patients with sarcopenia had lower survival (10.09 months) than those without (11.72 months). The ALBI, MELD and MELD-sarcopenia were associated with mortality. ALBI had AUROC of 0.717 (95% CI: 0.659 - 0.771), MELD had AUROC of 0.656 (95% CI: 0.595 - 0.713) and MELD-sarcopenia had AUROC of 0.798 (95% CI: 0.744 - 0.845). The ALBI and MELD scores had comparable AUROC (p=0.081). The MELD-sarcopenia had superior AUROC than MELD (p=0.001) and ALBI (p=0.05).
CONCLUSION
MELD-sarcopenia is better prognostic model than the ALBI and MELD scores in HCC patients awaiting liver transplantation.
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背景
白蛋白-胆红素（ALBI）评分和终末期肝病模型（MELD）评分在肝细胞癌（HCC）患者中具有预后价值。本研究旨在比较 MELD 评分联合骨骼肌指数（MELD-sarcopenia）与 MELD 评分和 ALBI 评分在 HCC 患者肝移植中的应用。
方法
纳入 262 例 HCC 患者，随访 12 个月。计算基线 MELD、ALBI 和 MELD-sarcopenia 模型。
结果
患者平均年龄为 59.61±8.09 岁，其中男性占 69.5%，CTP 分级为 A 级（55.7%），BCLC 分期为 B 期（54.2%）。大多数患者（88.9%）的肝硬化原因为丙型肝炎病毒感染。平均 MELD、MELD-sarcopenia 和中位 ALBI 评分分别为 10.65±2.54、15.11±6.22 和-2.12（0.74）。存在骨骼肌减少症的患者 MELD、ALBI 和 MELD-sarcopenia 评分均较高。存在骨骼肌减少症的患者生存时间（10.09 个月）较无骨骼肌减少症患者（11.72 个月）低。ALBI、MELD 和 MELD-sarcopenia 与死亡率相关。ALBI 评分的 AUROC 为 0.717（95%CI：0.659-0.771），MELD 评分的 AUROC 为 0.656（95%CI：0.595-0.713），MELD-sarcopenia 评分的 AUROC 为 0.798（95%CI：0.744-0.845）。ALBI 和 MELD 评分的 AUROC 无显著差异（p=0.081），而 MELD-sarcopenia 评分的 AUROC 显著高于 MELD（p=0.001）和 ALBI（p=0.05）。
结论
在 HCC 患者肝移植中，MELD-sarcopenia 评分是比 ALBI 和 MELD 评分更好的预后模型。
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