Predictive value of ALBI score and PALBI score in assessing the risk of liver insufficiency or liver failure after hepatectomy
10.3760/cma.j.cn115355-20230825-00067
- VernacularTitle:ALBI评分和PALBI评分评估原发性肝细胞癌肝切除术后肝功能不全或肝功能衰竭发生风险的价值
- Author:
Zeyu HOU
1
;
Jun XU
Author Information
1. 山西医科大学第一临床医学院，太原 030001
- Keywords:
Carcinoma, hepatocellular;
Hepatic insufficiency;
Liver failure;
Albumins;
Bilirubin;
Blood platelets
- From:
Cancer Research and Clinic
2023;35(12):904-909
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of preoperative albumin-bilirubin (ALBI) score and platelet-albumin-bilirubin (PALBI) score in evaluating the risk of post-hepatectomy liver dysfunction (PLD) or post-hepatectomy liver failure (PHLF) of primary hepatocellular carcinoma (HCC).Methods:The clinical data of 106 primary HCC patients who received partial liver resection in the First Hospital of Shanxi Medical University from April 2018 to January 2023 were retrospectively analyzed. According to the presence of PLD or PHLF complication or not based on 50-50 criteria, all recipients were divided into PLD or PHLF group and non-PLD or non-PHLF group. The differences of preoperative serological detection indexes were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors of PLD or PHLF in primary HCC patients. The 50-50 criteria was taken as the gold standard, and the receiver operating characteristic (ROC) curve was used to assess the efficacy of ALBI score and PALBI score in judging of PLD or PHLF of primary HCC patients.Results:Among the 106 HCC patients, 13 cases (12.26%) of them suffered PLD or PHLF, while 93 cases (87.74%) did not. The age of patients in PLD or PHLF group and non-PLD or non-PHLF group was (60±7) years, (58±10) years, respectively; and there were 10 cases (76.92%) males, 69 cases (74.19%) males, respectively in both groups. There were statistically significant differences in aspartate aminotransferase, γ glutamyl transpeptidase, total bilirubin, albumin, tumor diameter, Child-Pugh score, ALBI score and PALBI score before operation between the two groups (all P < 0.05). The results of multivariate regression analysis showed that Child-Pugh score ( HR = 2.250, 95% CI 1.097-4.615, P = 0.027), ALBI score ( HR = 10.374, 95% CI 2.767-38.890, P = 0.001) and PALBI score ( HR = 33.074, 95% CI 4.677-233.894, P < 0.001) were independent influencing factors of PLD or PHLF in primary HCC patients ( P < 0.05). ROC curve result showed that the area under the curve of Child-Pugh score for predicting PLD or PHLF in HCC patients was 0.647 (95% CI 0.548-0.738), the area under the curve of ALBI score was 0.791 (95% CI 0.701-0.864), and the area under the curve of PALBI score was 0.794 (95% CI 0.704-0.866). The optimal cut-off value of Child-Pugh score for predicting PLD or PHLF in primary HCC patients was 6.500, the sensitivity was 38.5%, and the specificity was 92.5%. The optimal cut-off value of ALBI score for predicting PLD or PHLF in primary HCC patients was -2.345, the sensitivity was 76.9%, and the specificity was 77.4%. The optimal cut-off value of PALBI score for predicting PLD or PHLF in primary HCC patients was -2.050, the sensitivity was 69.2%, and the specificity was 92.5%. Conclusions:Both PALBI score and ALBI score is better than Child-Pugh score in the predictive efficacy of PLD or PHLF for primary HCC patients after hepatectomy.
