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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