The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation.
The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation.
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DOI：
10.1155/2021/3514827
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Yin X
中科院分区：
文献类型：
--
作者：
Liu W;Zhang F;Quan B;Li M;Lu S;Li J;Chen R;Yin X
白蛋白与γ-谷氨酰转移酶比值（AGR）是一种新开发的用于预测实体瘤患者预后的生物标志物。本研究的目的是建立一种新的基于AGR的诺模图来预测接受射频消融（RFA）的早期HCC患者的肿瘤预后。将394例接受RFA作为初始治疗的肝细胞癌（HCC）患者分为培训队列和验证队列。通过单因素和多因素分析确定独立的预后因素。通过一致性指数（C-index）、受试者工作特征（ROC）曲线和似然比检验（LAT）评价AGR的价值。采用逻辑回归和列线图建立基于临床变量的治疗前评分模型。因此，AGR = 0.63被确定为预测训练队列中总生存期（OS）的最佳截止值。多因素分析结果显示，AGR是影响OS和无复发生存期（RFS）的独立指标。在训练队列和验证队列中，高AGR组的RFS和OS均优于低AGR组。此外，C指数、ROC曲线下面积和LAT χ2值表明AGR在预测OS方面优于Child-Pugh（CP）分级和白蛋白胆红素（ALBI）分级。此外，Hosmer-Lemeshow检验和校准曲线分析的结果显示，训练和验证队列中的列线图在校准方面表现良好。因此，基于AGR的诺模图可以预测接受RFA的早期HCC患者的术后预后。
Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients' prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index (C-index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the C-index, area under the ROC curves, and LAT χ2 values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.
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