纤维蛋白原与前白蛋白比值对肝细胞癌术后预后的预测价值  

The value of fibrinogen/prealbumin ratio in predicting the prognosis of hepatocellular carcinoma after operation

作　　者：徐小尚 蔡蓓蓓 章龙珍 XU Xiaoshang;CAI Beibei;ZHANG Longzhen(Department of Oncology,Suqian Hospital Affiliated to Xuzhou Medical University(Suqian People's Hospital of Nanjing Drum-Tower Hospital Group),Jiangsu Suqian 223800,China;Department of Cancer Radiotherapy,Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属宿迁医院(南京鼓楼医院集团宿迁市人民医院)肿瘤科,江苏宿迁223800 [2]徐州医科大学附属医院肿瘤放疗科,江苏徐州221002

出　　处：《现代肿瘤医学》2021年第18期3224-3228,共5页Journal of Modern Oncology

基　　金：江苏省卫生计生委科研课题(编号:Z201651)。

摘　　要：目的:研究纤维蛋白原(Fib)与前白蛋白(PA)比值(FPR)对肝细胞癌(HCC)术后预后的预测价值。方法:回顾性分析2010年7月至2014年7月我院收治的245例HCC患者的临床资料,通过计算FPR,绘制受试者工作特征(ROC)曲线分析其对HCC患者预后的诊断价值。通过单因素及Cox回归多因素风险模型分析影响HCC患者预后生存的危险因素。结果:HCC患者1、3、5年的总生存率分别为73.06%、40.82%、30.20%。单因素分析显示,Child-Pugh分级、TNM分期、门静脉癌栓、肿瘤数目、FPR、肿瘤直径、TBil、Alb、ALT、AST、Fib和PA指标与HCC患者预后显著相关,差异有统计学意义(P<0.05)。多因素分析显示,门静脉癌栓、肿瘤数目、肿瘤直径、Alb、ALT、FPR是影响HCC患者预后的独立危险因素(P<0.05)。ROC曲线显示,FPR预测HCC患者预后的cut-off值为19.295,曲线下面积为0.738,灵敏度为54.1%,特异度为81.3%,阳性预测值为75.4%,阴性预测值为63.6%,约登指数为0.3538,FPR在预测HCC患者预后方面较其他各项预后指标具有较高的预测价值。结论:FPR与HCC患者预后关系密切,是影响患者预后的独立危险因素,其预测HCC患者预后诊断价值较高,可指导临床上改善患者的高凝状态和营养状况,从而提高预后。Objective:To study the predictive value of fibrinogen(Fib)/prealbumin(PA)ratio(FPR)in postoperative prognosis of hepatocellular carcinoma(HCC).Methods:Clinical data of 245 cases of HCC patients admitted to our hospital from July 2010 to July 2014 were retrospectively analyzed.By calculating FPR and drawing receiver operating characteristic(ROC)curve,the diagnostic value of FPR for the prognosis of HCC patients was analyzed.Univariate and Cox regression multivariate risk models were used to analyze the risk factors affecting the prognosis and survival of HCC patients.Results:The 1,3 and 5-year overall survival rates of HCC patients were 73.06%,40.82%and 30.20%,respectively.Univariate analysis showed that Child-Pugh grade,TNM stage,portal vein tumor thrombus,number of tumor,FPR,tumor diameter,TBil,Alb,ALT,AST,Fib and PA were significantly correlated with the prognosis of HCC patients,with statistical significance(P<0.05).Multivariate analysis showed that portal vein tumor thrombus,number of tumor,tumor diameter,Alb,ALT and FPR were independent risk factors affecting the prognosis of HCC patients(P<0.05).ROC curve showed that the cut-off value of FPR for predicting the prognosis of HCC patients was 19.295.The area under the curve was 0.738.The sensitivity was 54.1%.The specificity was 81.3%.The positive predictive value was 75.4%.The negative predictive value was 63.6%,and the Youden index was 0.3538.Compared with other prognostic indicators,FPR had a higher predictive value in predicting the prognosis of HCC patients.Conclusion:FPR is closely related to the prognosis of HCC patients,and is an independent risk factor affecting the prognosis of HCC patients.FPR has a high diagnostic value in predicting the prognosis of HCC patients,and can guide the improvement of hypercoagulable state and nutritional status of patients,so as to improve the prognosis.

关 键 词：肝细胞癌 纤维蛋白原 前白蛋白 预后 

分 类 号：R735.7[医药卫生—肿瘤]