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术前白蛋白-碱性磷酸酶比值影响肝癌手术患者的预后。

Preoperative albumin-alkaline phosphatase ratio affects the prognosis of patients undergoing hepatocellular carcinoma surgery.

机构信息

Department of Hepatobiliary, Pancreas and Spleen Surgery, Guangxi Academy of Medical Sciences, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

Institute of Health Management, Guangxi Academy of Medical Sciences, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

出版信息

Cancer Biomark. 2024;39(1):15-26. doi: 10.3233/CBM-230108.

Abstract

BACKGROUND

The correlation between the preoperative albuminalkaline phosphatase ratio (AAPR) and the prognosis of hepatocellular carcinoma (HCC) patients after radical resection is still not comprehensive.

OBJECTIVE

This study aims to observe the correlation between preoperative AAPR and the prognosis of HCC patients after radical resection.

METHODS

We constructed a retrospective cohort study and included 656 HCC patients who underwent radical resection. The patients were grouped after determining an optimum AAPR cut-off value. We used the Cox proportional regression model to assess the correlation between preoperative AAPR and the prognosis of HCC patients after radical resection.

RESULTS

The optimal cut-off value of AAPR for assessing the prognosis of HCC patients after radical resection was 0.52 which was acquired by using X-tile software. Kaplan-Meier analysis curves showed that a low AAPR (⩽ 0.52) had a significantly lower rate of overall survival (OS) and recurrence-free survival (RFS) (P< 0.05). Multiple Cox proportional regression showed that an AAPR > 0.52 was a protective factor for OS (HR = 0.66, 95%CI 0.45-0.97, p= 0.036) and RFS (HR = 0.70, 95% CI 0.53-0.92, p= 0.011).

CONCLUSIONS

The preoperative AAPR level was related to the prognosis of HCC patients after radical resection and can be used as a routine preoperative test, which is important for early detection of high-risk patients and taking personalized adjuvant treatment.

摘要

背景

术前白蛋白碱性磷酸酶比值(AAPR)与肝癌(HCC)患者根治性切除术后预后的相关性尚不完全明确。

目的

本研究旨在观察术前 AAPR 与 HCC 患者根治性切除术后预后的相关性。

方法

我们构建了一项回顾性队列研究,纳入了 656 例行根治性切除术的 HCC 患者。在确定最佳 AAPR 截断值后,对患者进行分组。我们采用 Cox 比例风险回归模型评估术前 AAPR 与 HCC 患者根治性切除术后预后的相关性。

结果

使用 X-tile 软件得出,评估 HCC 患者根治性切除术后预后的 AAPR 最佳截断值为 0.52。Kaplan-Meier 分析曲线表明,低 AAPR(⩽0.52)的总生存(OS)和无复发生存(RFS)率显著降低(P<0.05)。多因素 Cox 比例风险回归分析显示,AAPR>0.52 是 OS(HR=0.66,95%CI 0.45-0.97,p=0.036)和 RFS(HR=0.70,95%CI 0.53-0.92,p=0.011)的保护因素。

结论

术前 AAPR 水平与 HCC 患者根治性切除术后的预后相关,可作为常规术前检查,有助于早期发现高危患者并采取个体化辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42d3/10977408/d21c6db761c0/cbm-39-cbm230108-g001.jpg

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