AST/ALT 比值在接受热消融联合同步 TACE 治疗的肝细胞癌患者中的预后作用。
The prognostic role of the AST/ALT ratio in hepatocellular carcinoma patients receiving thermal ablation combined with simultaneous TACE.
机构信息
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
出版信息
BMC Gastroenterol. 2023 Mar 21;23(1):80. doi: 10.1186/s12876-023-02719-1.
BACKGROUND
To evaluate the prognostic value of the pre-treatment aspartate transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC) patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with simultaneous TACE.
METHODS
The data for 117 patients were retrospectively analyzed in this study. The endpoint of prognosis was overall survival (OS). The Youden index was used to choose the optimal cut-off value of the pre-treatment AST/ALT ratio for OS prediction. Univariate and multivariate analyses were used to identify independent risk factors, then integrated to establish the nomogram.
RESULTS
The AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with a higher AST/ALT ratio had poorer OS. The median OS for the high-value AST/ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5 months (P = 0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP, and tumor numbers were independent prognostic indicators for OS. The integrated nomogram showed higher predictive accuracy for OS (C-index 0.674, 95%CI: 0.600-0.748).
CONCLUSIONS
The preoperative AST/ALT ratio could be a prognostic indicator for HCC patients receiving thermal ablation combined with simultaneous TACE.
背景
评估接受射频消融（RFA）/微波消融（MWA）联合同期 TACE 治疗的肝细胞癌（HCC）患者治疗前天门冬氨酸氨基转移酶（AST）/丙氨酸氨基转移酶（ALT）比值的预后价值。
方法
本研究回顾性分析了 117 例患者的数据。预后终点为总生存期（OS）。采用约登指数选择预测 OS 的最佳 AST/ALT 比值截断值。采用单因素和多因素分析确定独立危险因素，然后整合建立列线图。
结果
用于预测 OS 的 AST/ALT 比值截断值为 0.89，AST/ALT 比值较高的患者 OS 较差。高 AST/ALT 组的中位 OS 未达到，而低 AST/ALT 组的中位 OS 为 48.5 个月（P = 0.0047）。单因素和多因素分析表明，AST/ALT 比值、AFP 和肿瘤数目是 OS 的独立预后因素。整合的列线图显示对 OS 的预测准确性更高（C 指数 0.674，95%CI：0.600-0.748）。
结论
术前 AST/ALT 比值可作为接受热消融联合同期 TACE 治疗的 HCC 患者的预后指标。
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