Preoperative prealbumin level as an independent predictor of long-term prognosis after liver resection for hepatocellular carcinoma: a multi-institutional study
Preoperative prealbumin level as an independent predictor of long-term prognosis after liver resection for hepatocellular carcinoma: a multi-institutional study
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术前前白蛋白水平作为肝细胞癌肝切除术后长期预后的独立预测因子：一项多机构研究
DOI：
10.1016/j.hpb.2018.06.1803
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发表时间：
2019-02-01
期刊：
影响因子：
2.9
通讯作者：
Yang, Tian
中科院分区：
文献类型：
--
作者：
Li, Ju-Dong;Xu, Xin-Fei;Yang, Tian
背景：血清前白蛋白是反映营养状况和肝功能的敏感而稳定的指标。术前前白蛋白水平是否与肝细胞癌（HCC）患者行肝切除术的长期预后相关尚不清楚。方法：2001年至2014年在6家机构接受肝切除术的HCC患者入选。以术前前白蛋白水平170 mg/L为界值，将这些患者分为低前白蛋白组和正常前白蛋白组。结果：1483例患者中，437例（29%）患者前白蛋白水平较低。低前白蛋白组患者的3年和5年OS和RFS率分别为57和31%，40和20%，显著低于正常前白蛋白组（分别为76和43%，56和28%，均p < 0.001）。多因素Cox回归分析显示术前前白蛋白水平是OS的独立预测因子（HR，1.45，95% CI：1.24-1.70，p < 0.001）和RFS（HR，1.28，95% CI：1.10-1.48，p < 0.001）。术前血清前白蛋白水平可用于预测肝癌切除术后患者的远期预后。
Background: Serum prealbumin is a sensitive and stable marker for nutritional status and liver function. Whether preoperative prealbumin level is associated with long-term prognosis in patients undergoing liver resection for hepatocellular carcinoma (HCC) is unclear.Methods: Patients who underwent liver resection for HCC between 2001 and 2014 at six institutions were enrolled. These patients were divided into the low and normal prealbumin groups using a cut-off value of 170 mg/L for preoperative prealbumin level. The overall survival (OS) and recurrence-free survival (RFS) were compared between them.Results: In 1483 patients, 437 (29%) had a low prealbumin level. The 3- and 5-year OS and RFS rates of patients in the low-prealbumin group were 57 and 31%, and 40 and 20%, respectively, which were significantly poorer than those in the normal-prealbumin group (76 and 43%, and 56 and 28%, respectively, both p < 0.001). Multivariable Cox-regression analyses revealed that preoperative prealbumin level was an independent predictor of OS (HR, 1.45, 95% CI: 1.24-1.70, p < 0.001) and RFS (HR, 1.28, 95% CI: 1.10-1.48, p < 0.001).Conclusions: Preoperative prealbumin level could be used in predicting long-term prognosis for patients undergoing liver resection for HCC.