Prediction of Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma by Evaluation Index of Liver Fibrosis
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0608
- VernacularTitle:肝纤维化评价指标预测肝癌患者肝切除术后肝功能衰竭
- Author:
Shui-rong LIN
1
;
Hao-zhong LIN
1
;
Bai-feng QIAN
1
;
Mu-qi LI
1
;
Hong PENG
2
;
Yun-peng HUA
1
;
Bao-gang PENG
1
;
Shun-li SHEN
1
Author Information
1. Department of Hepatic Surgery， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
2. Department of Biliary and Pancreatic Surgery， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
hepatocellular carcinoma;
aspartate aminotransferase-to-platelet ratio index;
liver fibrosis-4 index;
posthepatectomy liver failure;
Child-Pugh score
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):874-882
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe aspartate aminotransferase-to-platelet ratio index （APRI） and liver fibrosis-4 index （FIB-4） have been used for noninvasive prediction of liver fibrosis and cirrhosis and both indexes exhibit a high degree of accuracy in the the prediction of the prognosis of hepatocellular carcinoma（HCC）patients after hepatectomy.. This study aims to explore the predictive values of APRI and FIB-4 in the occurrence of posthepatectomy liver failure （PHLF） in HCC patients. MethodsThe clinical data of 426 patients with HCC who underwent hepatectomy in our hospital were retrospectively analyzed. Laboratory data were collected from patients within 2 weeks prior to hepatectomy. APRI， FIB-4 and Child-Pugh scores were calculated. Receiver operating characteristic （ROC） curves were used to determine the AUC values and optimal cut-off values of APRI， FIB-4 and Child-Pugh scores. Univariate and multivariate logistic regression analyses were employed to identify the independent risk factors for PHLF， and the predictive values of APRI and FIB-4 on PHLF were compared. ResultsA total of 48 patients （11.3%） developed PHLF. Multivariate analysis showed that major hepatectomy （≥3 segments resection）， blood loss >400 mL， total bilirubin （TBIL）， platelet （PLT）， fibrinogen （Fib）， APRI and FIB-4 were independent risk factors for PHLF. ROC curve analysis revealed that APRI （AUC = 0.816） and FIB-4 （AUC = 0.728） had better ability to predict PHLF than Child-Pugh score （AUC = 0.566； P<0.001）. ConclusionsPreoperative APRI and FIB-4 are independent predictors of PHLF in HCC patients after hepatectomy and have good predictive values.
