Alanine aminotransferase to hemoglobin ratio is an indicator for disease progression for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization
Alanine aminotransferase to hemoglobin ratio is an indicator for disease progression for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization
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丙氨酸氨基转移酶与血红蛋白的比率是接受经导管动脉化疗栓塞的肝细胞癌患者疾病进展的指标
DOI：
10.1007/s13277-015-4082-y
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发表时间：
2016-03-01
期刊：
影响因子：
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通讯作者：
Lin, Qu
中科院分区：
文献类型：
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作者：
Lin, Zhi-Huan;Li, Xing;Lin, Qu
肝细胞癌（HCC）患者接受经导管动脉化疗栓塞（TACE）的预后远未确定。本研究旨在评估血细胞计数、常规肝功能检查和丙氨酸氨基转移酶与血红蛋白比值（AHR）在预测这些患者无进展生存期（PFS）中的作用。回顾性分析了243例接受TACE的HCC患者。根据Akaike信息标准（AIC）指数和线性趋势χ2，确定肝癌意大利程序（CLIP）评分系统是该患者亚组的最佳评分系统。然后，通过整合到CLIP评分系统中来确定参数的预后价值。因此，证实AHR是接受TACE的HCC患者PFS的独立预测因子（p= 0.001），其他参数未达到统计学显著性。此外，AHR通过调节CLIP来改善CLIP的性能，从而提高其区分能力。AHR定义≤0.4583为低水平，>0.4583为高水平。同时，患者也被相应地分为两组。与AHR水平较高的患者相比，接受TACE且AHR水平较低的HCC患者的1年DCR较高（41.9% vs 18.1%）。此外，AHR水平与预后因素，如较低的ALP，总胆红素，和门静脉血栓形成。总之，本研究首次将AHR确定为接受TACE的HCC患者的独立预后因素。AHR较低的HCC患者亚组表现出较好的疾病控制，是TACE的理想候选者。
The prognosis of hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) is far from being identified. The present study aimed to assess the role of blood cell counts, routine liver function tests, and alanine aminotransferase to hemoglobin ratio (AHR) in predicting the progression-free survival (PFS) of these patients. A total of 243 HCC patients receiving TACE were analyzed retrospectively. Cancer of the Liver Italian Program (CLIP) score system was indentified to be the best score system for this patient subgroup according to the Akaike information criterion (AIC) index and linear trendχ2. Then, prognostic value of parameters was determined by integration into the CLIP score system. As a result, AHR was confirmed to be an independent predictor for the PFS of HCC patients receiving TACE (p= 0.001) with the other parameters failing to reach statistical significance. Moreover, AHR improved the performance of CLIP by adjusting into it, thus improving its discriminatory ability. AHR defined ≤0.4583 as low level and >0.4583 as high level. And, patients were also dichotomized into two groups accordingly. HCC patients receiving TACE with low AHR presented higher 1 year DCR (41.9 vs 18.1 %) compared with patients with high AHR levels. Furthermore, AHR level was associated with prognostic factors such as lower ALP, total bilirubin, and portal vein thrombosis. In summary, the present study firstly indentified AHR as an independent prognostic factor in HCC patients receiving TACE. The subgroup of HCC patients with lower AHR presented preferable disease control and were the idealistic candidates for TACE.