Toyoda Hidenori, Johnson Philip J
Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
JHEP Rep. 2022 Aug 18;4(10):100557. doi: 10.1016/j.jhepr.2022.100557. eCollection 2022 Oct.
The (albumin-bilirubin) 'ALBI' score is an index of 'liver function' that was recently developed to assess prognosis in patients with hepatocellular carcinoma, irrespective of the degree of underlying liver fibrosis. Other measures of liver function, such as model for end-stage liver disease (MELD) and Child-Pugh score, which were introduced for specific clinical scenarios, have seen their use extended to other areas of hepatology. In the case of ALBI, its application has been increasingly extended to chronic liver disease in general and in some instances to non-liver diseases where it has proven remarkably accurate in terms of prognosis. With respect to chronic liver disease, numerous publications have shown that ALBI is highly prognostic in patients with all types and stages of chronic liver disease. Outside of liver disease, ALBI has been reported as being of prognostic value in conditions ranging from chronic heart failure to brain tumours. Whilst in several of these reports, explanations for the relationship of liver function to a clinical condition have been proposed, it has to be acknowledged that the specificity of ALBI for liver function has not been clearly demonstrated. Nonetheless, and similar to the MELD and Child-Pugh scores, the lack of any mechanistic basis for ALBI's clinical utility does not preclude it from being clinically useful in certain situations. Why albumin and bilirubin levels, or a combination thereof, are prognostic in so many different diseases should be studied in the future.
（白蛋白-胆红素）“ALBI”评分是一种“肝功能”指标，它是最近为评估肝细胞癌患者的预后而制定的，无论潜在肝纤维化程度如何。其他肝功能指标，如终末期肝病模型（MELD）和Child-Pugh评分，最初是针对特定临床情况引入的，如今其应用已扩展到肝病学的其他领域。就ALBI而言，其应用已越来越多地扩展到一般慢性肝病，在某些情况下还扩展到非肝脏疾病，事实证明它在预后方面非常准确。关于慢性肝病，大量出版物表明，ALBI在所有类型和阶段的慢性肝病患者中都具有很高的预后价值。在肝病之外，据报道ALBI在从慢性心力衰竭到脑肿瘤等多种病症中都具有预后价值。虽然在其中一些报告中，已经提出了肝功能与临床病症之间关系的解释，但必须承认，ALBI对肝功能的特异性尚未得到明确证实。尽管如此，与MELD和Child-Pugh评分类似，ALBI临床效用缺乏任何机制基础并不妨碍它在某些情况下具有临床实用性。未来应该研究为什么白蛋白和胆红素水平或它们的组合在如此多不同疾病中具有预后价值。
