血清前白蛋白总胆红素比值在肝脏TACE术患者预后评估中的应用价值

Application value of serum total bilirubin ratio of prealbumin in prognosis evaluation of patients undergoing liver TACE

目的探讨前白蛋白总胆红素比值评估经肝动脉化疗栓塞术(TACE)预后的价值。方法回顾性分析我院2012年5月~2017年5月133例行TACE术的原发性肝癌患者的详细资料,把术前、术后3d的前白蛋白与总胆红素比值作为研究指标。应用ROC曲线计算预测2年生存的最佳截断值,生存率采用Kaplan-Meier法,使用Cox行多因素分析。结果患者均行介入治疗,前白蛋白总胆红素比值术前中位数为6.85,术后3d中位数为3.92,表现为明显下降;ROC曲线显示术前﹑术后3d预测2年生存的最佳截断值为6.877、3.955,其中术后前白蛋白总胆红素比值对患者预后有更好的诊断价值;术前和术后的高低两组生存率差异有统计学意义(χ~2=24.966、53.969,P<0.05);肿瘤直径、肿瘤数目、白蛋白及前白蛋白总胆红素比值是影响总体生存时间的独立危险因素。结论前白蛋白总胆红素比值可作为评估患者预后的实用指标。

Objective To explore the value of serum total bilirubin ratio of prealbumin in evaluating the prognosis of patients undergoing TACE.Methods The detailed data of 133 patients with primary liver cancer who underwent TACE from May 2012 to May 2017 in our hospital were analyzed.The total bilirubin ratio of prealbumin before and after TACE were collected as the research index.The optimal cutoff value of 2-year survival was calculated by ROC curve,and the survival rate was calculated by Kaplan-Meier curve.Results All patients were treated with interventional therapy.The preoperative median value of the serum total bilirubin ratio of prealbumin was 6.85,and the postoperative median value was 3.92.The ROC curve showed that the best cut-off point for predicting 2-year survival was 6.877 and 3.955,among which the preoperative and postoperative median value of total bilirubin was better for the prognosis of patients value.The difference of survival rate between the high and low groups was statistically significant before and after operation(χ2=24.966,53.969,P<0.05).Tumor diameter,tumor number,albumin and the total bilirubin ratio of prealbumin were the independent risk factors affecting the overall survival time of patients.Conclusion Total bilirubin ratio of prealbumin can be used as a practical index to evaluate the prognosis of patients.