摘要
目的探讨血清白蛋白-胆红素评分(ALBI评分)联合纤维化-4指数(FIB-4指数)预测HBV相关肝细胞癌(HCC)患者肝切除术后肝衰竭(PHLF)的价值。方法回顾性分析122例接受肝切除术治疗的HBV相关HCC患者的临床资料,采用单因素和多因素logistic回归分析PHLF发生的影响因素,绘制ROC曲线评估术前Child-Pugh评分、终末期肝病模型(MELD)评分、ALBI评分、FIB-4指数和ALBI评分联合FIB-4指数对HBV相关HCC患者发生PHLF的预测价值。结果122例患者中有31例(25.4%)发生PHLF。单因素和多因素logistic回归分析结果均显示,ALBI评分和FIB-4指数升高是HBV相关HCC患者PHLF发生的危险因素(P<0.05)。ALBI评分和FIB-4指数预测PHLF发生的AUC高于Child-Pugh评分和MELD评分(P<0.05);ALBI评分联合FIB-4指数预测PHLF发生的AUC高于ALBI评分和FIB-4指数(P<0.05)。取ALBI评分的最佳诊断界值为-2.25分时,其预测PHLF发生的灵敏度和特异度分别为74.2%和72.5%;取FIB-4指数的最佳诊断界值为5.22时,其预测PHLF发生的灵敏度和特异度分别为61.3%和93.4%;取ALBI评分联合FIB-4指数的最佳诊断界值为-17.99时,其预测PHLF发生的灵敏度和特异度分别为87.1%和89.0%。结论ALBI评分联合FIB-4指数可作为预测HBV相关HCC患者发生PHLF的指标。
Objective To investigate the value of serum albumin-bilirubin score(ALBI score)combined with fibrosis-4 index(FIB-4 index)in predicting the development of posthepatectomy liver failure(PHLF)in the patients with HBV-related hepatocellular carcinoma(HCC).Methods The clinical data of 122 patients with HBV-related HCC underwent hepatectomy were retrospectively analyzed.Univariate and multivariate logistic regression analyses were used to determine the influencing factors for the occurrence of PHLF.ROC curve was drawn to evaluate the predictive value of preoperative Child-Pugh score,model for end-stage liver disease(MELD)score,ALBI score,FIB-4 index and the combination of ALBI score and FIB-4 index for the occurrence of PHLF in HBV-related HCC patients.Results Thirty-one(25.4%)patients developed PHLF.Univariate and multivariate logistic regression analyses showed that the elevated ALBI score and FIB-4 index were the risk factors for the occurrence of PHLF in HBV-related HCC patients(P<0.05).ALBI score and FIB-4 index had a significantly higher AUC than Child-Pugh score and MELD score(P<0.05).The combination of ALBI score and FIB-4 index had a significantly higher AUC than ALBI score or FIB-4 index alone(P<0.05).Taking-2.25 points as the optimal cut-off value of ALBI score,the sensitivity and specificity for predicting PHLF were 74.2%and 72.5%,respectively.Taking 5.22 as the optimal cut-off value of FIB-4 index,the sensitivity and specificity for predicting PHLF were 61.3%and 93.4%,respectively.Taking-17.99 as the optimal cut-off value of the combination of ALBI score and FIB-4 index for predicting PHLF,the sensitivity and specificity were 87.1%and 89.0%,respectively.Conclusion The combination of ALBI score and FIB-4 index can be used as a predictor of PHLF in HBV-related HCC patients.
作者
潘健
张晓锋
李伟
PAN Jian;ZHANG Xiaofeng;LI Wei(Department of Hepatobiliary Surgery,Lianyungang First People's Hospital,Jinzhou Medical University Postgraduate Training Base,Lianyungang 222061,CHINA)
出处
《江苏医药》
2023年第12期1227-1232,共6页
Jiangsu Medical Journal
