Predictive value of preoperative C-reactive protein to albumin ratio for microvascular invasion and early postoperative recurrence of hepatocellular carcinoma
10.3760/cma.j.cn115396-20240719-00226
- VernacularTitle:术前C反应蛋白/白蛋白比值对肝癌微血管侵犯和术后早期复发的预测价值
- Author:
Jie SUN
1
;
Jian ZHANG
;
Deshun LIU
;
Wei WEI
;
Qi WANG
;
Qizhu FENG
;
Chao ZHANG
Author Information
1. 安徽理工大学第一附属医院肝胆外科，淮南 232001
- Keywords:
Carcinoma, hepatocellular;
Microvascular invasion;
C-reactive protein;
Serum albumin;
Forecasting
- From:
International Journal of Surgery
2024;51(12):840-846
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of preoperative C-reactive protein to albumin ratio (CAR) in predicting microvascular invasion (MVI) and early postoperative recurrence of hepatocellular carcinoma(HCC).Methods:A retrospective cross-sectional study was conducted to analyze the clinical data of 190 patients with hepatocellular carcinoma who underwent radical resection in the First Affiliated Hospital of Anhui University of Science and Technology and the First Affiliated Hospital of Anhui Medical University from January 2020 to April 2022. The patients were divided into MVI group ( n=57) and non-MVI group ( n=133) according to whether there was microvascular invasion in postoperative pathology. The systemic inflammatory response index (SIRI), systemic immunoinflammatory index(SII), fibrinogen to albumin ratio (FAR) and CAR were calculated. 190 patients were followed up for 2 years after surgery. 86 patients had a recurrence, of whom 45 were in the MVI group and 41 were in the non-MVI group. SIRI, SII, FAR and CAR of the two groups were observed. And the value of SIRI, SII, FAR and CAR in predicting MVI and early postoperative recurrence was determined by receiver operating characteristic(ROC) curve. Univariate and multifactorial analysis of MVI risk factors in HCC. Quantitative data data consistent with normal distribution were represented by ( ± s), and independent sample t test was used for comparison between groups. Quantitative data that did not conform to normal distribution were represented by quartile M( Q1, Q3), and comparison between groups was performed by Mann-Whitney U test. Qualitative data were compared using chi-square test. Multivariate Logistic regression analysis was used for multivariate analysis. Results:There were 86 patients with early recurrence after operation, the recurrence rate was 45.26%. Among them, 45 cases (78.95%) recurred in MVI group and 41 cases (30.83%) in non-MVI group. There were 9 deaths (15.79%) in MVI group and 5 deaths (3.76%) in non-MVI group. There were differences in recurrence and death between MVI group and non-MVI group ( P<0.05). CAR was better than SIRI, SII and FAR in predicting MVI of hepatocellular carcinoma ( P<0.05). The area under ROC curve (AUC), sensitivity and specificity of CAR were 0.651, 70.20% and 60.20%, respectively, and the best predictive value was 0.01. CAR was an independent risk factor for MVI ( OR=1.068, 95% CI: 0.819-1.393, P<0.05). CAR was better than SIRI, SII and FAR in predicting early postoperative recurrence ( P<0.05). AUC, sensitivity and specificity of CAR were 0.641, 55.40% and 73.80%, and the predicted value was 0.01. Conclusion:Preoperative CAR is a risk factor for MVI in HCC, which can predict the occurrence of MVI and early recurrence after operation.
