Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.
Clin Transl Sci. 2023 May;16(5):850-860. doi: 10.1111/cts.13493. Epub 2023 Feb 22.
The albumin-bilirubin (ALBI) score was originally used to accurately assess liver dysfunction and predict the prognoses of patients with hepatocellular carcinoma. Following its more recent application to patients with gastrointestinal tumors, this study analyzed the prognostic value of the ALBI score in Chinese patients with advanced resectable (tumor-node-metastasis [TNM] stages I-III) gastric cancer (GC). This study investigated 1185 patients with advanced GC, including 429 with TNM stage I. The patients were divided into training and verifications groups (593 and 592 patients, respectively) in which these patients were classified as high risk (ALBI score ≥ -2.65) or low risk (ALBI score < -2.65). Univariate and multivariate Cox regression analyses were performed, and a visual survival prediction model (nomogram) was created. On Kaplan-Meier analysis, patients who were low-risk and high-risk according to their ALBI scores had significantly different survival rates in both the training and verification groups (p < 0.01). The difference was also significant when analyzing only patients with TNM stage I GC (p = 0.031). Univariate and multivariate analyses showed that the ALBI score (p = 0.014), age (p < 0.001), Nutritional Risk Screening 2002 score (p = 0.024), sarcopenia (p = 0.049), tumor differentiation (p = 0.027), and TNM stage (p < 0.001) were independent risk factors for survival. Our survival prediction model that incorporated the ALBI score accurately predicted the 5-year survival rate of Chinese patients with GC. Therefore, the ALBI score is a valid clinical indicator and good predictor of survival after surgery for progressive GC. Moreover, this score is simple to derive and does not burden patients with additional costs.
ALBI 评分最初用于准确评估肝功能并预测肝细胞癌患者的预后。在最近将其应用于胃肠道肿瘤患者后,本研究分析了 ALBI 评分在中国可切除(肿瘤-淋巴结-转移 [TNM] 分期 I-III 期)胃癌(GC)患者中的预后价值。本研究纳入了 1185 例进展期 GC 患者,其中 429 例为 TNM 分期 I 期。患者被分为训练组和验证组(593 例和 592 例),根据 ALBI 评分将这些患者分为高危(ALBI 评分≥-2.65)或低危(ALBI 评分<-2.65)。进行单因素和多因素 Cox 回归分析,并创建了可视化生存预测模型(列线图)。在 Kaplan-Meier 分析中,根据 ALBI 评分高低分组的患者在训练组和验证组中的生存率有显著差异(p<0.01)。仅分析 TNM 分期 I 期 GC 患者时差异也具有统计学意义(p=0.031)。单因素和多因素分析显示,ALBI 评分(p=0.014)、年龄(p<0.001)、2002 年营养风险筛查评分(p=0.024)、肌肉减少症(p=0.049)、肿瘤分化程度(p=0.027)和 TNM 分期(p<0.001)是生存的独立危险因素。我们的生存预测模型纳入 ALBI 评分后能够准确预测中国 GC 患者的 5 年生存率。因此,ALBI 评分是进展期 GC 患者手术预后的有效临床指标和良好预测指标。此外,该评分计算简便,不会给患者带来额外费用负担。