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