Construction of a predictive model for acute liver failure after hepatectomy based on neutrophil-to-lymphocyte ratio and albuminbilirubin score  

作　　者：Xiao-Pei Li Zeng-Tao Bao Li Wang Chun-Yan Zhang Wen Yang 

机构地区：[1]Department of Family Planning and Assisted Reproductive Technology,The First People’s Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China [2]Department of Gastrointestinal Surgery,The First People’s Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China [3]Department of Laboratory Medicine,The First People’s Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China [4]Department of Gynecology,The First People’s Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第4期1087-1096,共10页世界胃肠外科杂志（英文版）（电子版）

基　　金：reviewed and approved by the Ethics Committee of the First People’s Hospital of Lianyungang,No.LW-20231120001-01.

摘　　要：BACKGROUND Acute liver failure(ALF)is a common cause of postoperative death in patients with hepatocellular carcinoma(HCC)and is a serious threat to patient safety.The neutrophil-to-lymphocyte ratio(NLR)is a common inflammatory indicator that is associated with the prognosis of various diseases,and the albumin-bilirubin score(ALBI)is used to evaluate liver function in liver cancer patients.Therefore,this study aimed to construct a predictive model for postoperative ALF in HCC tumor integrity resection(R0)based on the NLR and ALBI,providing a basis for clinicians to choose appropriate treatment plans.AIM To construct an ALF prediction model after R0 surgery for HCC based on NLR and ALBI.METHODS In total,194 patients with HCC who visited The First People’s Hospital of Lianyungang to receive R0 between May 2018 and May 2023 were enrolled and divided into the ALF and non-ALF groups.We compared differences in the NLR and ALBI between the two groups.The risk factors of ALF after R0 surgery for HCC were screened in the univariate analysis.Independent risk factors were analyzed by multifactorial logistic regression.We then constructed a prediction model of ALF after R0 surgery for HCC.A receiver operating characteristic curve,calibration curve,and decision curve analysis(DCA)were used to evaluate the value of the prediction model.RESULTS Among 194 patients with HCC who met the standard inclusion criteria,46 cases of ALF occurred after R0(23.71%).There were significant differences in the NLR and ALBI between the two groups(P<0.05).The univariate analysis showed that alpha-fetoprotein(AFP)and blood loss volume(BLV)were significantly higher in the ALF group compared with the non-ALF group(P<0.05).The multifactorial analysis showed that NLR,ALBI,AFP,and BLV were independent risk factors for ALF after R0 surgery in HCC.The predictive efficacy of NLR,ALBI,AFP,and BLV in predicting the occurrence of ALT after R0 surgery for HCC was average[area under the curve(AUC)NLR=0.767,AUCALBI=0.755,AUCAFP=0.599,AUCBLV=0.718].The predict

关 键 词：Acute liver failure Hepatocellular carcinoma HEPATECTOMY Neutrophil-to-lymphocyte ratio Albumin-bilirubin score 

分 类 号：R619[医药卫生—外科学] R692[医药卫生—临床医学]