ALBI分级评估胆道支架联合^125I粒子植入治疗晚期肝外胆管癌的预后分析

Prognostic value of ALBI grading in biliary stenting combined with^125I seed implantation for advanced extrahepatic cholangiocarcinoma

目的探究白蛋白-胆红素(ALBI)分级对胆道支架联合^125I粒子植入治疗晚期肝外胆管癌的预后评估价值。方法2015年12月至2018年12月铜陵市人民医院收治的65例晚期肝外胆管癌患者,比较不同ALBI分级的肝外胆管癌患者临床资料、治疗效果、预后,采用spearman相关分析ALBI分级与肝外胆管癌患者临床资料、治疗效果、预后的相关性,采用受试者工作特征曲线(ROC)分析ALBI分级对肝外胆管癌患者预后的预测价值。结果不同ALBI分级的肝外胆管癌患者糖类抗原19-9(CA19-9)、C反应蛋白(CRP)、总胆红素(TBIL)、白蛋白(ALB)、治疗效果、预后差异有统计学意义(P<0.05);ALBI 3级的肝外胆管癌患者1年生存率显著低于ALBI 1~2级的肝外胆管癌患者(P<0.05);ALBI分级与肝外胆管癌患者CA19-9、CRP、治疗效果、预后呈正相关(P<0.05);ALBI分级预测肝外胆管癌患者预后的AUC为0.785(95%CI:0.670~0.900),敏感性为76.70%,特异性为80.00%,准确性为78.35%。结论ALBI分级对胆道支架联合^125I粒子植入治疗晚期肝外胆管癌的疗效评估和预后判断具有重要价值。

Objective To investigate the prognostic value of albumin-bilirubin(ALBI)grading in the treatment of advanced extrahepatic cholangiocarcinoma with biliary stenting combined with^125I seed implantation.Methods Included were 65 patients with advanced extrahepatic cholangiocarcinoma admitted to Tongling People’s Hospital between December 2015 and December 2018.The subjects were compared for clinical data,treatment efficacy,and prognosis according to different ALBI grades.Spearman’s correlation analysis was used to analyze the association between ALBI grades,clinical data,treatment efficacy,and prognosis,and receiver operating characteristic curve(ROC)was used to analyze the prognostic value of ALBI grades,in patients with extrahepatic cholangiocarcinoma.Results In these patients,there were statistical differences in serum levels of carbohydrate antigen 19-9(CA19-9),C-reactive protein(CRP),total bilirubin(TBIL)and albumin(ALB),as well as in treatment efficacy and prognosis according to different ALBI grades(P<0.05).Patients with ALBI grade 3 extrahepatic cholangiocarcinoma had significantly lower one-year survival rate than those with ALBI grades 1 and 2 disease(P<0.05).The ALBI grade was positively correlated with CA19-9 and CRP levels,treatment efficacy,and prognosis(P<0.05).The area under curve(AUC)for ALBI grades in predicting the prognosis of extrahepatic cholangiocarcinoma was 0.785(95%CI:0.670~0.900),with a sensitivity of 76.70%,a specificity of 80.00%,and an accuracy of 78.35%.Conclusion ALBI grading is of great value in evaluating the efficacy and prognosis in advanced extrahepatic cholangiocarcinoma treated with biliary stenting combined with^125I seed implantation.