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李曹杰, 李嘉浚, 徐叶, 等. 天冬氨酸氨基转移酶与血小板比值指数与纤维化-4指数对肝癌切除术后患者预后的预测价值[J]. 中国临床医学, 2024, 31(2): 186-191. DOI: 10.12025/j.issn.1008-6358.2024.20231977
引用本文: 李曹杰, 李嘉浚, 徐叶, 等. 天冬氨酸氨基转移酶与血小板比值指数与纤维化-4指数对肝癌切除术后患者预后的预测价值[J]. 中国临床医学, 2024, 31(2): 186-191. DOI: 10.12025/j.issn.1008-6358.2024.20231977
LI Caojie, LI Jiajun, XU Ye, et al. The predictive value of aspartate aminotransferase-to-platelet ratio index and fibrosis-4 index for the prognosis of patients with hepatocellular carcinoma after resection[J]. Chinese Journal of Clinical Medicine, 2024, 31(2): 186-191. DOI: 10.12025/j.issn.1008-6358.2024.20231977
Citation: LI Caojie, LI Jiajun, XU Ye, et al. The predictive value of aspartate aminotransferase-to-platelet ratio index and fibrosis-4 index for the prognosis of patients with hepatocellular carcinoma after resection[J]. Chinese Journal of Clinical Medicine, 2024, 31(2): 186-191. DOI: 10.12025/j.issn.1008-6358.2024.20231977

天冬氨酸氨基转移酶与血小板比值指数与纤维化-4指数对肝癌切除术后患者预后的预测价值

The predictive value of aspartate aminotransferase-to-platelet ratio index and fibrosis-4 index for the prognosis of patients with hepatocellular carcinoma after resection

  • 摘要:
    目的 探讨肝硬化血液生化指标天冬氨酸氨基转移酶与血小板比值指数(APRI)、纤维化-4指数(FIB-4)对肝癌切除术后患者预后的预测价值。
    方法 回顾性收集2005年2月至2017年7月在复旦大学附属中山医院行肝癌根治性切除300例患者的临床病理资料、肝癌复发和生存情况,分析APRI、FIB-4与肝癌患者术后复发、生存的关系,应用ROC曲线评价APRI、FIB-4对肝癌切除术后患者预后的预测价值。
    结果 300例患者的中位随访时间为61个月。单因素Cox回归分析显示,APRI、FIB-4、血管侵犯是影响肝癌患者术后无复发生存期(DFS)、总生存期(OS)的危险因素;多因素Cox回归分析显示,血管侵犯是影响肝癌患者术后DFS(HR=1.518,95% CI 1.024~2.252,P=0.038)、OS(HR=2.301,95% CI 1.270~4.167,P=0.006)的独立危险因素。时间依赖ROC(time-ROC)结果显示,APRI、FIB-4预测术后1年、3年和5年DFS的曲线下面积(AUC)为0.555~0.596,预测术后1年、3年和5年OS的AUC为0.600~0.679。
    结论 基于血液生化检测的肝硬化指标APRI与FIB-4对肝癌患者术后预后的预测价值有限。

     

    Abstract:
    Objective To explore whether liver cirrhosis markers aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) based on blood biochemical indicators can predict disease free survival (DFS) and overall survival (OS) in patients with hepatocellular carcinoma (HCC) after resection.
    Methods 300 patients with HCC who underwent radical resection in Zhongshan Hospital, Fudan University from February 2005 to July 2017 were enrolled and the clinicopathological characteristics, recurrence and survival of these patients were retrospectively collected. The relationships between APRI, FIB-4 and postoperative recurrence and survival were evaluated. The ROC curve was used to evaluate the predictive values of APRI, FIB-4.
    Results The median follow-up of 300 patients was 61 months. Univariate Cox regression analysis showed that APRI, FIB-4, vascular invasion were risk factors affecting postoperative DFS and OS. The multivariate Cox regression analysis showed that vascular invasion was the independent risk factor for postoperative DFS (HR=1.518, 95%CI 1.024-2.252, P=0.038) and OS (HR=2.301, 95%CI 1.270-4.167, P=0.006). The time dependent ROC (time-ROC) curve showed that AUCs of APRI and FIB-4 predicting 1-year, 3-year, and 5-year DFS were 0.555-0.596, which were 0.600-0.679 when predicting 1-year, 3-year, and 5-year OS.
    Conclusions The predictive value of APRI and FIB-4 based on blood biochemical indicators alone for postoperative DFS and OS in HCC patients is limited.

     

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