Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection
Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection
复制标题
血清前白蛋白与肝细胞癌患者肝切除后的生存呈负相关
DOI：
10.7150/jca.30903
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Li, Le-Qun
中科院分区：
文献类型：
--
作者：
Liao, Ying-Yang;Teng, Chun-Lan;Li, Le-Qun
目的：低血清白蛋白水平与某些类型癌症的不良预后相关。然而，前白蛋白在肝细胞癌（HCC）患者中的作用尚不清楚。本研究旨在探讨血清白蛋白前水平在肝切除术后HCC患者长期生存中的作用。方法：回顾性分析某三级肝脏中心2007年6月至2015年12月行肝切除术的HCC患者。根据200mg /L的临界值将患者分为正常或降低的血清前白蛋白。分析两组患者的总生存率及复发率。使用倾向评分分析来减少由于基线时其他患者差异造成的偏倚。结果：本研究共纳入1349例行肝切除术的HCC患者，其中男性1168例（86.6%），女性181例（13.4%）。血清前白蛋白正常的患者总生存率明显高于血清前白蛋白降低的患者（P < 0.001）。在倾向分析和基于肝硬化的亚组分析后观察到类似的结果。此外，血清前白蛋白正常的患者复发率明显低于血清前白蛋白降低的患者（P < 0.001）。结论：术前血清白蛋白水平低与肝切除术后HCC患者较差的长期生存有关。低血清前白蛋白可能是鉴别肝切除术后预后不良高危患者的一个标志。
Objective: Low serum prealbumin levels are associated with poor prognoses in some type of cancers. However, the role of prealbumin in patients with hepatocellular carcinoma (HCC) is unknown. The present study aimed to investigate the role of serum prealbumin levels in long-term survival for HCC patients after hepatic resection. Methods: HCC patients who underwent hepatic resection from June 2007 to December 2015 were retrospectively analyzed in a tertiary liver center. Patients were classified as having normal or reduced serum prealbumin based on a cut-off value of 200 mg/L. Overall survival and recurrence rate were analyzed between groups. Propensity score analysis was used to reduce bias due to other patient differences at baseline. Results: A total of 1349 HCC patients who underwent hepatic resection were enrolled on this study, including 1168 (86.6%) male and 181 (13.4%) female. Patients with normal serum prealbumin had significantly higher overall survival than those with reduced serum prealbumin (P < 0.001). Similar findings were observed after propensity analysis and subgroup analysis based on liver cirrhosis. Moreover, patients with normal serum prealbumin had a significantly lower recurrence rate than those with reduced serum prealbumin (P < 0.001). Conclusions: Low preoperative level of serum prealbumin is associated with poor long-term survival in patients with HCC after hepatic resection. Low serum prealbumin may be a marker to identify patients at high risk of poor prognosis after hepatic resection.