Value of albumin-bilirubin score combined with aspartate aminotransferase-to-platelet ratio index in predicting the development of posthepatectomy liver failure in patients with HBV-related hepatocellular carcinoma

• Main Author: MAI Rongyun
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2018-02-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=8756
• ISSN: 1001-5256; 1001-5256

ObjectiveTo investigate the value of albumin-bilirubin (ALBI) score combined with aspartate aminotransferase-to-platelet ratio index (APRI) in predicting the development of posthepatectomy liver failure (PHLF) in patients with HBV-related hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the patients with HBV-related HCC who underwent hepatectomy in The Affiliated Tumor Hospital of Guangxi Medical University from January 2006 to October 2013. With Child-Pugh score as control, the values of ALBI, APRI, and ALBI combined with APRI in predicting PHLF were analyzed. The chi-square test or the Fisher exact test was used for comparison of categorical data between groups, and the logistic regression model was used to identify independent predictive indices for PHLF. ResultsA total of 1055 patients were enrolled in this study, among whom 151 (14.3%) experienced PHLF. The univariate and multivariate analyses showed that ALBI and APRI were significantly associated with the prognosis of PHLF patients (P＜0.001). ALBI and APRI had a significantly higher area under the receiver operating characteristic curve (AUC) than Child-Pugh score (both P＜0001). ALBI had a sensitivity of 78.1% and a specificity of 55.8% in predicting PHLF at the optimal cut-off value of -2.77, and the patients with ALBI ＞-2.77 had a significantly higher incidence rate of PHLF A/B/C than those with ALBI ≤-2.77(P＜0.001). APRI had a sensitivity of 61.6% and a specificity of 71.0% in predicting PHLF at the optimal cut-off value of 0.85, and the patients with APRI ＞0.85 had a significantly higher incidence rate of PHLF A/B/C than those with APRI ≤0.85(P＜0.001). The combination of ALBI and APRI had a significantly higher AUC than ALBI or APRI (P＜0.001 and P=0.047). The combination of ALBI and APRI had a sensitivity of 78.1% and a specificity of 62.2% in predicting PHLF at the optimal cut-off value of -13.10, and the patients with the combination of ALBI and APRI ＞-13.10 had a significantly higher incidence rate of PHLF A/B/C than those with the combination of ALBI and APRI ≤-13.10(P＜0.001). ConclusionALBI combined with APRI can be used as a new, convenient, and reliable index for predicting PHLF.