优化肝细胞癌的预后精度：整合 PWR 与 ALBI 和 PALPI 评分。

Optimizing Prognostic Precision in Hepatocellular Carcinoma: Integrating PWR with ALBI and PALPI Scores.

机构信息

Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.

出版信息

Asian Pac J Cancer Prev. 2024 Sep 1;25(9):3067-3072. doi: 10.31557/APJCP.2024.25.9.3067.

DOI:10.31557/APJCP.2024.25.9.3067

PMID:39342584

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11700341/

Abstract

BACKGROUND

Enhancing prognostication in Hepatocellular Carcinoma (HCC) remains an unmet need, especially in patients with preserved liver function. This study aimed to integrate the Platelet-to-White Blood Cell Ratio (PWR) with albumin-bilirubin (ALBI) and platelets-albumin-bilirubin (PALBI) scores for improved assessment of mortality and treatment responses in hepatocellular carcinoma (HCC) patients.

METHODS

In this prospective study, 262 patients with hepatocellular carcinoma (HCC) were included, with basic data collected and followed up for one year or until death. All prognostic scores were calculated by integrating the PWR with the ALBI and PALBI scores, examining their relationship with treatment responses and mortality rates.

RESULTS

The patients were mainly males (69.5%), aged 59.6 ± 8.09 years. The predictive power of the integrated PALBI+PWR score at different time points 1 (P 0.004), 3 months, and 6 months (P 0.004) overpowered all other scores. However, late at the 12-month follow-up, ALBI score had reported superiority on PALPI+PWR (AUC 0.631, 0.617), respectively. Regression analyses confirmed the high performance of PALBI+PWR factors in influencing treatment response (P 0.009-OR 0.562 (0.365 - 0.867)). Regarding mortality prediction, PALPI+PWR proved the highest efficacy in regression analysis (P <0.001) OR (2.451 (1.555 - 3.862).

CONCLUSION

Integrating PWR with the PALBI score enhances prognostic precision in patients with HCC, offering improved predictive power for treatment responses and mortality in the early stages of HCC with preserved liver function.

摘要

背景

提高肝细胞癌（HCC）的预后仍然是一个未满足的需求，特别是在肝功能正常的患者中。本研究旨在将血小板与白细胞比值（PWR）与白蛋白-胆红素（ALBI）和血小板-白蛋白-胆红素（PALBI）评分相结合，以改善对肝细胞癌（HCC）患者死亡率和治疗反应的评估。

方法

在这项前瞻性研究中，纳入了 262 名肝细胞癌（HCC）患者，收集了基本数据并进行了为期一年或直至死亡的随访。通过将 PWR 与 ALBI 和 PALBI 评分相结合，计算所有预后评分，检查它们与治疗反应和死亡率之间的关系。

结果

患者主要为男性（69.5%），年龄 59.6±8.09 岁。在不同时间点 1 个月（P<0.004）、3 个月和 6 个月（P<0.004），整合后的 PALBI+PWR 评分的预测能力均优于其他所有评分。然而，在 12 个月的随访晚期，ALBI 评分在 PALPI+PWR 方面表现出优势（AUC 0.631，0.617）。回归分析证实了 PALBI+PWR 因素在影响治疗反应方面的高表现（P<0.009-OR 0.562（0.365-0.867））。关于死亡率预测，PALPI+PWR 在回归分析中表现出最高的疗效（P<0.001）OR（2.451（1.555-3.862））。