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采用改良白蛋白血小板乘积对与酒精相关的癌症发病率和死亡率进行分层。

Alcohol-related cancer morbidity and mortality are stratified using modified albumin platelet product.

机构信息

Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Saiwai 1-1, Takamatsu, Kagawa, 760-8521, Japan.

Department of Medical Technology, Kagawa Prefectural University of Health Sciences, 281-1 Hara, Mure, Takamatsu, Kagawa, 761-0123, Japan.

出版信息

Sci Rep. 2024 Jan 11;14(1):1052. doi: 10.1038/s41598-023-50778-x.

DOI:10.1038/s41598-023-50778-x
PMID:38200049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10781945/
Abstract

Alcohol abuse is associated with several diseases, such as hepatocellular carcinoma, cirrhosis, and extrahepatic malignancies. Recently, we reported albumin platelet product (APP) and modified APP (mAPP) as novel indices of liver fibrosis staging and prognosis in patients without alcoholic liver diseases. This retrospective cohort study aimed to extend application of APP and mAPP in prognosis prediction of patients with alcoholic liver diseases. We enrolled 222 patients with alcoholic liver diseases based on their medical records. Cut-off values of APP = 4.349 and mAPP = 2.484 were adopted based on a past report. Hazard ratios of APP and mAPP were compared to those of albumin-bilirubin score and fibrosis-4 index. The primary and secondary endpoints were carcinogenesis and death, respectively. Thus, APP = 4.349 and mAPP = 2.484 significantly differentiated cancer-free survival and overall survival in univariate analysis. Hazard ratios of mAPP = 2.484 were greater than those of the albumin-bilirubin score of -2.270 and fibrosis-4 index of 3.25. Multivariate analysis revealed mAPP = 2.484 as an independent risk factor for carcinogenesis and overall death. In conclusion, mAPP is a simple index to stratify patient's risk for carcinogenesis and death.

摘要

酒精滥用与多种疾病相关,如肝细胞癌、肝硬化和肝外恶性肿瘤。最近,我们报道了白蛋白血小板乘积(APP)和改良 APP(mAPP)作为无酒精性肝病患者肝纤维化分期和预后的新型指标。本回顾性队列研究旨在扩展 APP 和 mAPP 在酒精性肝病患者预后预测中的应用。我们根据病历招募了 222 名酒精性肝病患者。根据过去的报告,采用 APP=4.349 和 mAPP=2.484 的截断值。APP 和 mAPP 的风险比与白蛋白-胆红素评分和纤维化-4 指数的风险比进行了比较。主要终点和次要终点分别为癌变和死亡。因此,在单因素分析中,APP=4.349 和 mAPP=2.484 显著区分了无癌生存和总生存。mAPP=2.484 的风险比大于白蛋白-胆红素评分的-2.270 和纤维化-4 指数的 3.25。多因素分析显示 mAPP=2.484 是癌变和总死亡的独立危险因素。总之,mAPP 是一种简单的指标,可用于分层患者的癌变和死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/10eb940b1223/41598_2023_50778_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/9374dee0e422/41598_2023_50778_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/668ff59a44d0/41598_2023_50778_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/10eb940b1223/41598_2023_50778_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/9374dee0e422/41598_2023_50778_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/668ff59a44d0/41598_2023_50778_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6787/10781945/10eb940b1223/41598_2023_50778_Fig3_HTML.jpg

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本文引用的文献

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Alcohol and Cancer: Epidemiology and Biological Mechanisms.酒精与癌症:流行病学与生物学机制。
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Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study.2020 年全球归因于酒精消费的癌症负担:一项基于人群的研究。
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Albumin platelet product as a novel score for liver fibrosis stage and prognosis.白蛋白血小板乘积作为一种新的肝纤维化分期和预后评分。
Sci Rep. 2021 Mar 5;11(1):5345. doi: 10.1038/s41598-021-84719-3.
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Albumin-bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C.白蛋白-胆红素评分可指示慢性丙型肝炎患者的肝纤维化分期及预后。
Hepatol Res. 2019 Jul;49(7):731-742. doi: 10.1111/hepr.13333. Epub 2019 May 17.
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Cardiovascular effects of alcohol: A double-edged sword / how to remain at the nadir point of the J-Curve?酒精对心血管的影响:一把双刃剑/如何保持 J 曲线的最低点?
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Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function.白蛋白-胆红素分级在日本46681例肝细胞癌患者全国性调查中的验证、潜力及预后评估:对肝功能进行更详细评估的必要性
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