ALBI联合剩余肝体积对HBV相关原发性肝癌患者肝切除术后肝衰竭发生的预测价值*

doi:10.3969/j.issn.1672-5069.2020.04.033

Abstract

Abstract: Objective The purpose of this study was to evaluate the value of albumin-bilirubin (ALBI) score and future liver remnant (FLR) combination in predicting the occurrence of post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods A total of 76 patients with HCC were recuited in our hospital between October 2015 and May 2019, and ALBI were obtained. All the patients underwent abdominal three-dimensional CT reconstruction and hepatectomy. Univariate and multivariate Logistic regression analysis were applied to explore the clinical influencing factors related to the occurrence of PHLF. The diagnostic values of the related index for the occurrence of PHLF were determined by receiver operating characteristic curve. Results Out of the 76 patients with HCC, 28 had PHLF and 48 hadn’t; the average age of patients with non-PHLF was (48.2±6.3) years, significantly younger than [(55.9±7.1) years, P<0.05], the INR was (0.9±0.1), significantly lower than [(1.1±0.1), P <0.05], serum albumin level was (40.6±3.2) g/L, significantly higher than [(36.4±3.1) g/L, P <0.05], blood platelet count was (241.2±80.3)×10⁹/l, significantly higher than [(181.9±60.8)×10⁹/l, P<0.05], the ALBI score was (-2.9±0.8), significantly lower than [(-1.8±1.0), P <0.05], the MELD score was (7.0±1.5), significantly lower than that [(8.4±1.9), P <0.05], the Child-Pugh score was (4.2±1.2), significantly lower than [(5.8±1.4), P <0.05], and the FLR was (890.6±210.6)cm³, significantly larger than [(720.1±180.7)cm³, P <0.05]in patients without PHLF; multivariate Logistic regression analysis showed that ALBI score and and FLR were the independent predictors of PHLF occurrence in patients with HCC (P <0.05); the sensitivity and specificity of ALBI and FLR combination in diagnosing PHLF in patients with HCC were 81.2% and 90.5%. Conclusion The application of ALBI and FLR for evaluating liver reserve function in patients with HCC before hepatectomy is feasible, and might guide the clinicians to make decisions and prevent the occurrence of PHLF.

Key words: Hepatocellular carcinoma, Post-hepatectomy liver failure, Albumin-bilirubin score, Future liver remnant, Logistic regression analysis

Feng Tao, Hu Wei, Teng Buwei, et al. Value of ALBI and future liver remnant combinationin predicting the occurrence of post-hepatectomy liver failure in patients with hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2020, 23(4): 585-588.

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Value of ALBI and future liver remnant combinationin predicting the occurrence of post-hepatectomy liver failure in patients with hepatocellular carcinoma

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