术前乳酸脱氢酶/白蛋白比值联合AFP评估肝细胞癌患者预后的价值

Value of Preoperative Lactate Dehydrogenase-to-Albumin Ratio Combined with AFP in Evaluating Prognosis of Patients with Hepatocellular Carcinoma

目的探讨术前乳酸脱氢酶/白蛋白比值(LAR)联合甲胎蛋白(AFP)评估肝细胞癌(HCC)患者预后的价值。方法回顾性分析106例HCC患者的临床资料;采用Kaplan-Meier法绘制生存曲线;采用单因素分析影响LAR的可能变量,应用Cox风险回归模型评估术前LAR和AFP对HCC患者预后的临床价值。结果高LAR组和高AFP组的无病生存期(DFS)和总生存期(OS)均短于低LAR组和低AFP组(P<0.05)。Cox多因素回归模型结果显示,LAR≥4.58、AFP≥400μg/L和T3~T4期是影响HCC患者DFS和OS的独立危险因素(P<0.05),术后行介入手术治疗是OS延长的独立影响因素(P<0.05)。高LAR且高AFP组患者DFS和OS最短,低LAR且低AFP组的DFS和OS最长,差异有统计学意义(P<0.05)。结论术前LAR、AFP是HCC的独立不良预后因素,术前LAR联合AFP对判断HCC患者预后有一定价值。

Objective To explore the value of preoperative LAR combined with AFP in evaluating the prognosis of patients with HCC.Methods We retrospectively analyzed the clinical data of 106 patients with HCC.Kaplan-Meier method was used to draw the survival curve.Univariate analysis was used to analyze possible variables affecting LAR.Cox risk regression model was used to evaluate the clinical value of preoperative LAR and AFP on the prognosis of HCC patients.Results The DFS and OS of the high LAR group and the high AFP group were shorter than those of the low LAR group and the low AFP group(P<0.05).LAR≥4.58,AFP≥400μg/L and T3-T4 were independent risk factors affecting DFS and OS of HCC patients(P<0.05).Postoperative interventional surgery was an independent factor influencing OS prolongation(P<0.05).The DFS and OS were the shortest in the high LAR and high AFP group,and the DFS and OS were the longest in the low LAR and low AFP group(P<0.05).Conclusion Preoperative LAR and AFP are independent poor prognostic factors of HCC.Preoperative LAR combined with AFP has a certain value in judging the prognosis of HCC patients.