Wang Yikai, Bi Xinyu, Zhao Hong, Li Zhiyu, Zhao Jianjun, Zhou Jianguo, Huang Zhen, Zhang Yefan, Chen Xiao, Zhang Chongda, Cai Jianqiang, Ren Yijun
Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China.
Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.
Oncol Lett. 2023 Mar 1;25(4):147. doi: 10.3892/ol.2023.13733. eCollection 2023 Apr.
This study aimed to investigate the prognostic value of the preoperative alkaline phosphatase-to-albumin ratio (APAR) in patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy. The clinicopathological data from 330 patients was retrospectively analyzed. Receiver operating characteristic curves of APAR for diagnostic tumor recurrence were plotted with a cut-off value of 1.74. A high preoperative APAR value was significantly associated with hepatitis B surface antigen level, tumor diameter, and tumor-node-metastasis stage. The disease-free survival (DFS) and overall survival (OS) of patients with a high preoperative APAR were shorter than those with a low APAR. The independent risk factors for DFS were an APAR ≥1.74, and macrovascular invasion or tumor thrombus. The independent risk factors for OS were an APAR ≥1.74, existing clinical symptoms, α-fetoprotein level ≥20 ng/ml, macrovascular invasion or tumor thrombus, and family history of cancer. In conclusion, a preoperative APAR (≥1.74) is an independent risk factor influencing the poor prognosis of patients with HCC after curative hepatectomy, and patients with such a result should be closely monitored.
本研究旨在探讨术前碱性磷酸酶与白蛋白比值（APAR）对接受根治性肝切除术的肝细胞癌（HCC）患者的预后价值。回顾性分析了330例患者的临床病理资料。绘制了诊断肿瘤复发的APAR的受试者工作特征曲线，截断值为1.74。术前APAR值高与乙肝表面抗原水平、肿瘤直径和肿瘤-淋巴结-转移分期显著相关。术前APAR高的患者的无病生存期（DFS）和总生存期（OS）短于术前APAR低的患者。DFS的独立危险因素为APAR≥1.74，以及大血管侵犯或肿瘤血栓。OS的独立危险因素为APAR≥1.74、存在临床症状、甲胎蛋白水平≥20 ng/ml、大血管侵犯或肿瘤血栓以及癌症家族史。总之，术前APAR（≥1.74）是影响HCC患者根治性肝切除术后预后不良的独立危险因素，该结果的患者应密切监测。
