中性粒细胞与淋巴细胞比值联合白蛋白-胆红素评分对不可切除乙型肝炎相关性肝细胞癌患者动脉化疗栓塞治疗转归的评估价值  

Evaluation value of NLR combined with ALBI score for outcomes of TACE in patients with unresectable hepatitis B-related hepatocellular carcinoma

作　　者：李虎[1] 黄永平[1] 缪军[1] 邢丽菊 LI Hu;HUANG Yongping;MIAO Jun;XING Liju(Interventional Vascular Surgery,Jiangyin Traditional Chinese Medicine Hospital,214400,China)

机构地区：[1]江阴市中医院介入血管外科,214400 [2]江阴市中医院介入血管外科肿瘤科,214400

出　　处：《传染病信息》2025年第2期109-115,共7页Infectious Disease Information

基　　金：江阴市中青年卫生优秀人才培养计划(JYROYT202316)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)联合白蛋白一胆红素(albumin-bilirubin,ALBI)评分对不可切除乙型肝炎(乙肝)相关性肝细胞癌(hepatocellular carcinoma,HCC)患者动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗转归的评估价值。方法选取2021年1月至2023年8月在江阴市中医院行TACE治疗的不可切除乙肝相关性HCC患者152例(HCC组)和同期来院体检健康者76例(对照组)纳人研究。根据HCC组患者TACE治疗1年后预后将其分为转归不良组(62例)和转归良好组(90例),计算NLR和ALBI评分。通过Pearson相关或Spearman秩相关分析不可切除乙肝相关性HCC患者NLR、ALBI评分与临床特征的相关性;多因素非条件Logistic回归分析NLR和ALBI评分与不可切除乙肝相关性HCC患者TACE治疗转归的关系,用受试者工作特征曲线分析NLR联合ALBI评分对不可切除乙肝相关性HCC患者TACE治疗转归的评估价值。结果与对照组比较,HCC组NLR和ALBI评分升高(P<0.05)。不可切除乙肝相关性HCC患者NLR、ALBI评分与中国肝癌分期、分化程度呈正相关(P均<0.05)。随访1年,152例不可切除乙肝相关性HCC患者TACE治疗转归不良率为40.79%(62/152)。与转归良好组比较,转归不良组NLR和ALBI评分升高(P<0.05)。中国肝癌分期IIIa-IIIb期、低分化、血管侵犯和NLR高、ALBI评分高为不可切除乙肝相关性HCC患者TACE治疗转归不良的独立危险因素(P均<0.05)。NLR联合ALBI评分评估不可切除乙肝相关性HCC患者TACE治疗转归的曲线下面积为0.848,大于NLR和ALBI评分单独评估的0.766、0.757。结论NLR和ALBI评分升高与不可切除乙肝相关性HCC患者TACE治疗转归不良有关,NLR联合ALBI评分对其有较高的评估价值。Objective To investigate the evaluation value of the neutrophil-to-lymphocyte ratio(NLR)combined with the albumin-bilirubin(ALBI)score for predicting the outcome of transcatheter arterial chemoembolization(TACE)in patients with unresectable hepatitis B-related hepatocellular carcinoma(HCC).Methods A total of 152 patients with unresectable hepatitis B-related HCC who underwent TACE in Jiangyin Traditional Chinese Medicine Hospital from January 2021 to August 2023(HCC group)and 76 healthy individuals(control group)were included.Based on 1-year post-TACE outcomes,HCC patients were divided into a adverse outcome group(n=62)and a good outcome group(n=90).NLR and ALBI scores were calculated.Correlations between NLR,ALBI scores,and clinical characteristics of unresectable hepatitis B-related HCC patients were analyzed using Pearson or Spearman correlation analysis.Multivariate unconditional logistic regression was used to analyze the relationship between NLR,ALBI scores,and TACE outcomes.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of NLR combined with ALBI scores for TACE outcomes.Results Compared with the control group,NLR and ALBI scores were significantly higher in the HCC group(P<O.05).In unresectable hepatitis B-related HCC patients,NLR and ALBI scores were positively correlated with China Liver Cancer(CNLC)stage and tumor differentiation degree(P<0.05).After 1 year of follow-up,the adverse outcome rate of TACE treatment in 152 unresectable hepatitis B-related HCC patients was 40.79%(62/152).Compared with the good outcome group,the adverse outcome group had significantly higher NLR and ALBI scores(P<0.05).CNLC stage IIIa-IIIb,poor differentiation,vascular invasion,high NLR,and high ALBI scores were independent risk factors for adverse TACE outcomes in patients with unresectable hepatitis B-related HCC(P<0.05).The area under the curve(AUC)for NLR combined with ALBI scores in predicting TACE outcomes was O.848,which was higher than the AUCs for NLR(0.766)and ALBI scores(0

关 键 词：乙肝相关性肝细胞癌 中性粒细胞与淋巴细胞比值 白蛋白-胆红素评分 肝动脉化疗栓塞 转归 

分 类 号：R735.7[医药卫生—肿瘤]