Zhen Wen-Chong, Sun Jing, Bai Xue-Ting, Zhang Qian, Li Zi-Han, Zhang Yi-Xin, Xu Rong-Xuan, Wu Wei, Yao Zhi-Han, Pu Chun-Wen, Li Xiao-Feng
School of Public Health, Dalian Medical University, Dalian 116044, Liaoning Province, China.
Graduate School, Dalian Medical University, Dalian 116044, Liaoning Province, China.
World J Gastroenterol. 2025 Jan 14;31(2):99349. doi: 10.3748/wjg.v31.i2.99349.
Chronic hepatitis B often progresses silently toward hepatocellular carcinoma (HCC), a leading cause of mortality worldwide. Early detection of HCC is crucial, yet challenging.
To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio (APR) in hepatitis B progression to HCC.
Data from 4843 patients with hepatitis B (January 2015 to January 2024) were analyzed. HCC incidence rates in males and females were compared using the log-rank test. Data were evaluated using Kaplan-Meier analysis. The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time. Furthermore, Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.
The incidence of HCC was higher in males. To ensure the model's normality assumption, this study applied a logarithmic transformation to APR, yielding ratio. Ratio levels were higher in females ( = 5.26, < 0.01). A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males (95%CI: 1.653-2.431) and a 2.273-fold higher risk in females (95%CI: 1.620-3.190).
Males are more prone to HCC, while females have higher APR levels. Despite no baseline APR link, rising APR indicates a higher HCC risk.
慢性乙型肝炎常悄然进展为肝细胞癌（HCC），这是全球主要的死亡原因。HCC的早期检测至关重要，但具有挑战性。
探讨碱性磷酸酶与前白蛋白比值（APR）的动态变化在乙型肝炎进展为HCC中的作用。
分析了4843例乙型肝炎患者（2015年1月至2024年1月）的数据。采用对数秩检验比较男性和女性的HCC发病率。使用Kaplan-Meier分析评估数据。应用线性混合效应模型追踪APR水平随时间的波动。此外，采用纵向和生存数据联合建模来研究APR与HCC风险之间随时间变化的关系。
男性的HCC发病率较高。为确保模型的正态性假设，本研究对APR进行对数转换，得到比值。女性的比值水平较高（=5.26，<0.01）。比值每增加1个单位，男性患HCC的风险高2.005倍（95%CI：1.653 - 2.431），女性高2.273倍（95%CI：1.620 - 3.190）。
男性更容易患HCC，而女性的APR水平较高。尽管基线APR无关联，但APR升高表明HCC风险较高。
