术前C-反应蛋白-白蛋白-淋巴细胞比值在肝细胞癌预后中的价值评估  

Evaluation of the prognostic value of preoperative C-reactive protein-albumin-lymphocyte ratio in patients with hepatocellular carcinoma

作　　者：丁丁 杨云川 马翔[1] 马中正 霍俊一 周磊[1] Ding Ding;Yang Yunchuan;Ma Xiang;Ma Zhongzheng;Huo Junyi;Zhou Lei(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院肝胆外科,233000

出　　处：《中华普通外科学文献（电子版）》2024年第4期261-265,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：蚌埠医学院自然科学重点项目(2021byzd109)。

摘　　要：目的探讨术前C-反应蛋白-白蛋白-淋巴细胞比值(CALLY指数)与肝细胞癌(HCC)患者预后之间的关系。方法回顾性分析2016年1月至2019年1月在蚌埠医学院第一附属医院行根治性手术治疗的122例HCC患者临床资料。绘制术前CALLY指数的受试者工作特征(ROC)曲线,确定术前CALLY指数的最佳截断值,比较术前CALLY指数高、低水平组HCC患者的临床病理特征,并分析影响HCC患者预后的危险因素。结果参考患者最终的生存状态,术前CALLY指数的最佳截断值为5.495,曲线下面积为0.753(95%CI:0.666~0.841),敏感度0.709,特异度0.761。术前外周血CALLY指数与微血管侵犯(MVI)、BCLC分期等临床病理因素有关(P<0.05)。生存预后曲线显示,术前CALLY指数低水平组患者术后1、3、5年总生存率(70.15%、44.78%、23.88%)明显低于高水平组患者(94.55%、78.18%、70.91%),低水平组患者术后1、3、5年无瘤生存率(65.67%、49.25%、14.93%)明显低于高水平组患者(90.91%、65.45%、34.55%),差异均有统计学意义(P<0.001)。多因素Cox分析结果显示,BCLC分期(HR=3.696,95%CI:2.229~6.127,P<0.001)、是否伴有MVI(HR=2.785,95%CI:1.691~4.588,P<0.001)、术前CALLY指数(HR=0.272,95%CI:0.153~0.484,P<0.001)均与患者总生存期有关联。结论术前CALLY指数有希望成为判断HCC患者预后的生物标志物。Objective To investigate the relationship between preoperative C-reactive protein-albumin-lymphocyte ratio(CALLY index)and prognosis in patients with hepatocellular carcinoma(HCC).Methods A retrospective analysis of clinical data of 122 HCC patients who underwent radical surgery at the First Affiliated Hospital of Bengbu Medical College from January 2016 to January 2019 was carried out.Receiver operating characteristic(ROC)curves of preoperative CALLY index were drawn to determine the optimal cut-off value of preoperative CALLY index.The clinical and pathological characteristics of HCC patients with high and low levels of preoperative CALLY index were compared,and the risk factors affecting the prognosis of HCC patients were analyzed.Results Referring to the final survival status of the patients,the optimal cut-off value for preoperative CALLY index was 5.495,the area under the curve was 0.753(95%CI:0.666-0.841),the sensitivity was 0.709 and the specificity was 0.761.The preoperative peripheral blood CALLY index was associated with clinical and pathological factors such as vascular invasion and BCLC staging(P<0.05).The survival prognostic curve showed that the 1-,3-,and 5-year overall survival rates(70.15%,44.78%,and 23.88%)of patients in the low-level preoperative CALLY index group were significantly lower than those in the high-level group(94.55%,78.18%,70.91%),so did the comparison results of the 1-,3-,and 5-year tumor-free survival rates(65.67%vs 90.91%,49.25%vs 65.45%,14.93%vs 34.55%,respectively).The differences were statistically significant(P<0.001).The results of multivariate Cox analysis showed that BCLC staging(HR=3.696,95%CI:2.229-6.127,P<0.001),presence of MVI(HR=2.785,95%CI:1.691-4.588,P<0.001),and preoperative CALLY index(HR=0.272,95%CI:0.153-0.484,P<0.001)were all significantly associated with overall survival.Conclusion Preoperative CALLY index has the potential to become a biomarker for predicting the prognosis of HCC patients.

关 键 词：CALLY指数 癌 肝细胞 预后 C-反应蛋白-白蛋白-淋巴细胞比值 

分 类 号：R735.7[医药卫生—肿瘤]