中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (12): 1407-1412.DOI: 10.19538/j.cjps.issn1005-2208.2023.12.18

• 论著 • 上一篇    下一篇

白蛋白-胆红素评分对肝细胞癌切除术后早期复发预测价值研究

凌帅波，李路豪，刘兆臣，李素新，李    林，刘胜炎，党晓卫   

  1. 郑州大学第一附属医院肝胆胰外科  河南省卫生健康委员会普通外科（肝胆胰）疾病精准诊疗重点实验室  河南省肝胆胰疾病微创诊治工程研究中心，河南郑州450052
  • 出版日期:2023-12-01 发布日期:2024-02-22

  • Online:2023-12-01 Published:2024-02-22

摘要： 目的    探讨肝细胞癌（HCC）切除术后早期复发的危险因素，评估白蛋白-胆红素（ALBI）评分对HCC切除术后早期复发的预测价值。方法    回顾性分析2016年1月至2020年12月郑州大学第一附属医院肝胆胰外一科诊断为HCC并行肝切除术病人的临床资料，根据术后2年内是否复发分为早期复发组（n=63，2年内复发）和非早期复发组（n=75，2年内未复发）。分析病人早期复发的危险因素，采用Kaplan-Meier法和Log-Rank检验比较不同等级ALBI组病人的无瘤生存率。结果    早期复发组和非早期复发组在肿瘤直径、微血管侵犯（MVI）、碱性磷酸酶、甲胎蛋白、ALBI分级方面差异有统计学意义（P＜0.05）。多因素Logistic回归分析显示，肿瘤直径（OR=2.201，95％CI 1.055～4.594，P=0.036）、MVI（OR=2.425，95％CI 1.058~5.562，P=0.036）和ALBI分级（OR=2.442，95％CI 1.130~5.279，P=0.023）是HCC切除术后早期复发的独立危险因素。不同等级ALBI组病人在术后6个月、1年、2年内复发存在差异（P＜0.05）。Kaplan-Meier无复发生存曲线显示高分级ALBI组病人复发率高于低分级ALBI组，差异有统计学意义（P＜0.05）。结论    术前ALBI评分对HCC切除术后早期复发有一定的预测价值，可用于HCC病人术后复发风险分层。

关键词: 肝细胞癌, 肝切除术, 白蛋白-胆红素评分, 早期复发

Abstract: Predictive value of ALBI score for early recurrence of hepatocellular carcinoma after liver resection        LING Shuai-bo, LI Lu-hao, LIU Zhao-chen, et al. Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University;Key Laboratory of Precision Diagnosis and Treatment in General Surgical (Hepatobiliary and Pancreatic) Diseases of Health Commission of Henan Province;Henan Province Engineering Research Center of Minimally Invasive Diagnosis and Treatment of Hepatobiliary and Pancreatic Diseases, Zhengzhou 450052, China
Corresponding author:DANG Xiao-wei,E-mail:dangxw1001@zzu.edu.cn
Abstract    Objective    To investigate the risk factors of early recurrence of hepatocellular carcinoma(HCC)after liver resection,and to evaluate the value of ALBI score in predicting early recurrence of HCC after liver resection. Methods    Clinical data of patients diagnosed with HCC combined with hepatectomy in the Department of Hepatopancreatobiliary Surgery,The First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were retrospectively collected and divided into two groups according to whether they had recurrence within 2 years after surgery:early recurrence group(n=63,recurrence within 2 years)and no early recurrence group(n=75,no recurrence within 2 years).The risk factors of early recurrence were analyzed.Kaplan-Meier method and Log-Rank test were used to compare the tumor-free survival rate of patients with different ALBI scores. Results    There were significant differences in maximum tumor diameter,microvascular invasion,alkaline phosphatase,alpha-fetoprotein and ALBI scores between early recurrence group and non-early recurrence group(P＜0.05). Multivariate Logistic regression analysis showed tumor diameter(OR=2.201,95％CI 1.055-4.594,P=0.036),MVI(OR=2.425,95%CI 1.058-5.562,P=0.036)and ALBI grade(OR=2.442,95%CI 1.130-5.279,P=0.023)are independent risk factors for early recurrence after HCC resection. There were differences in recurrence at 6 months,1 year and 2 years after resection in different ALBI groups(P＜0.05). Kaplan-Meier recurrence-free survival curve showed that the recurrence risk in high-grade ALBI group was higher than that in low-grade ALBI group,and the difference was statistically significant(P＜0.05). Conclusion    ALBI score has a certain value in predicting early recurrence after HCC resection,and can be used for risk stratification of postoperative recurrence in HCC patients.

Key words: hepatocellular carcinoma, hepatectomy, ALBI score, early recurrence