The prognostic value of aspartate aminotransferase-to-lymphocyte ratio index in early-stage hepatocellular carcinoma after hepatectomy: A propensity-score matched analysis
The prognostic value of aspartate aminotransferase-to-lymphocyte ratio index in early-stage hepatocellular carcinoma after hepatectomy: A propensity-score matched analysis
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DOI：
10.1111/ajco.13458
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发表时间：
2020-10-30
影响因子：
1.9
通讯作者：
Yang, Jiayin
中科院分区：
文献类型：
--
作者：
Chen, Yanyu;He, Chao;Yang, Jiayin
背景：术前天冬氨酸氨基转移酶/淋巴细胞比率指数(ALRI)升高可能预示各种癌症患者的生存率较低。然而，转氨酶/淋巴细胞比率指数(ALRI)在肝细胞癌患者中的预后价值仍有待确定。材料与方法对2007年2月至2016年3月在本院就诊的983例肝细胞癌患者进行了回顾性队列研究。采用倾向-得分匹配(PSM)方法校正选择偏差和混杂因素。使用局部加权散点图平滑(LOWESS)平滑拟合曲线，根据转氨酶/淋巴细胞比率指数(ALRI)绘制死亡和复发风险曲线。采用时间依赖的受试者工作特性(ROC)和Kaplan-Meier方法分析转氨酶/淋巴细胞比率指数(ALRI)在肝细胞癌中的作用。结果随着转氨酶/淋巴细胞比率指数(ALRI)的升高，肝细胞癌患者复发和死亡的风险增加。在时间依赖的ROC分析中，转氨酶/淋巴细胞比率指数预测1、3、5年OS的AUC值分别为0.668(95%CI：0.596~0.740)、0.605(95%CI：0.560~0.649)和0.613(95%CI：0.570~0.656)。转氨酶/淋巴细胞比率指数预测1、3、5年RFS的AUC值分别为0.598(95%CI：0.555~0.641)、0.590(95%CI：0.552~0.628)和0.604(95%CI：0.562~0.646)。转氨酶/淋巴细胞比率指数(ALRI)高的肝细胞癌患者总体存活率较低。COX回归分析显示，转氨酶/淋巴细胞比率指数(ALRI)是影响肝细胞癌患者预后的独立因素。结论术前血清转氨酶/淋巴细胞比率指数(ALRI)升高是预测肝癌患者预后的无创性、简便、有效的指标。
Background An elevated preoperative aspartate aminotransferase-to-lymphocyte ratio index (ALRI) may predict poor survival in various cancers. However, the prognostic value of aminotransferase-to-lymphocyte ratio index (ALRI) in patients with hepatocellular carcinoma (HCC) remains to be determined.Materials and methods A retrospective cohort study was conducted among 983 patients with HCC in our hospital from February 2007 to March 2016. A propensity-score matching (PSM) was performed to correct the selection bias and confounding factors. The risk of death and recurrence was plotted over aminotransferase-to-lymphocyte ratio index (ALRI) using the locally weighted scatterplot smoothing (LOWESS)-smoothed fit curve. Time-dependent receiver operating characteristic (ROC) and Kaplan-Meier method analysis was utilized to the role of aminotransferase-to-lymphocyte ratio index (ALRI) in HCC. Multivariate analysis was conducted to identify independent prognostic factors associated with overall survival (OS) and recurrence-free survival (RFS).Results With the increase of aminotransferase-to-lymphocyte ratio index (ALRI), the risk of recurrence and death in HCC patients increases. In time-dependent ROC analysis, the AUC of aminotransferase-to-lymphocyte ratio index (ALRI) for predicting 1-, 3- and 5-year OS were 0.668 (95% CI: 0.596-0.740), 0.605 (95% CI: 0.560-0.649) and 0.613 (95% CI: 0.570-0.656), respective. The AUC of aminotransferase-to-lymphocyte ratio index (ALRI) for predicting 1-, 3- and 5-year RFS were 0.598 (95% CI: 0.555-0.641), 0.590 (95% CI: 0.552-0.628) and 0.604 (95% CI: 0.562-0.646), respectively. HCC patients with high aminotransferase-to-lymphocyte ratio index (ALRI) had a poor overall survival. Moreover, cox regression analysis revealed that aminotransferase-to-lymphocyte ratio index (ALRI) was an independent factor affecting the prognosis of HCC patients.Conclusions Elevated preoperative aminotransferase-to-lymphocyte ratio index (ALRI) is a noninvasive, simple, and effective predictor in the prognosis of patients with HCC.