术前天冬氨酸氨基转移酶与白蛋白的比值在预测肝细胞癌患者术后预后中的价值  

Prognostic Significance of Preoperative Aspartate Aminotransferase to Albumin Ratio in Patients with Hepatocellular Carcinoma after Hepatic Resection

作　　者：王翊凯 毕新宇 赵宏 李智宇 赵建军 蔡建强 WANG Yikai;BI Xinyu;ZHAO Hong(National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100021)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,100021

出　　处：《实用癌症杂志》2018年第11期1741-1745,共5页The Practical Journal of Cancer

基　　金：国家高技术研究发展计划(863计划)(编号:2015AA020408)

摘　　要：目的探讨术前外周血天冬氨酸氨基转移酶与白蛋白的比值(AAR)在预测肝细胞癌患者术后预后中的价值。方法回顾性分析接受根治性肝切除术的330例肝细胞癌患者的临床数据。采用ROC曲线分析AAR预测肿瘤复发的最佳界值,根据AAR界值将患者分为高AAR组(AAR≥1)、低AAR组(AAR <1)。采用χ2检验分析AAR水平与临床病理特征的关系,生存分析采用Kaplan-Meier法和Log-rank检验,独立危险因素分析采用COX比例风险回归模型。结果诊断肝癌患者术后肿瘤复发的AAR最佳界值为1; AAR≥1跟肝硬化显著相关(P <0. 05);高AAR组的1、3年无复发生存率和总生存率显著低于低AAR组; AAR≥1、大血管侵犯或存在瘤栓是影响肝癌患者术后无复发生存期和总生存期的独立危险因素(P <0. 05)。结论术前AAR≥1是肝细胞癌患者术后预后的独立危险因素,术前AAR≥1的肝癌患者术后预后不良。Objective To investigate the prognostic value of preoperative aspartate aminotransferase to albumin ratio(AAR)in patients with hepatocellular carcinoma(HCC)undergoing curative hepatectomy.Methods Clinical pathological data of 330 HCC patients who underwent radical hepatotectomy were retrospectively analyzed.Receiver operating characteristic(ROC)curve of AAR for diagnostic tumor recurrence was plotted and the cut-off value was defined.The patients were divided into the high-AAR group(AAR≥1)and the low-AAR group(AAR<1).Correlations between AAR level and clinicopathological features were assessed by 2 test.The survival analysis was conducted by Kaplan-Meier method and Log-rank test.Independent risk factor analysis was conducted by COX proportional-hazards regression model.Results The cut-off value of AAR for diagnosing tumor recurrence after operation were 1.The AAR was significantly associated with liver cirrhosis(P<0.05).The patients with high AAR were associated with significantly shorter overall survival(OS)and relapse-free survival(RFS)than those with low AAR(P<0.05).The independent risk factors for relapse-free survival and overall survival were the preoperative AAR≥1 and macrovascular invasion or tumor thrombus.Conclusion Preoperative AAR is an independent risk factor influencing the prognosis of patients with hepatocellular carcinoma after hepatectomy.Patients with preoperative AAR≥1 have poor prognosis.

关 键 词：肝细胞癌 肝切除术 天冬氨酸氨基转移酶与白蛋白的比值 生存率 预后 

分 类 号：R735.7[医药卫生—肿瘤]