术前天冬氨酸氨基转移酶血小板比值对肝细胞癌切除术预后的分析

摘要

目的:探讨天冬氨酸氨基转移酶血小板比值(APRI)与肝细胞癌(HCC)手术预后的关系.方法:回顾分析在我院接受根治性切除术的228例HCC患者的临床资料.利用ROC曲线获得APRI值最佳截点为1.62,将患者分为低APRI组(APRI<1.62)和高APRI组(APRI≥1.62),比较分析两组患者的临床数据及预后.结果:术前APRI值同术前AST、PLT、HBsAg阳性率、肝脏纤维化、门脉癌栓密切相关.低APRI组患者术后总生存率(50%)显著高于高APRI组(31%)的患者(P<0.01).多因素分析显示术前APRI值、肿瘤最大横径、肿瘤数目、门静脉癌栓、肿瘤的TNM分期及分化程度均是影响HCC患者术后总生存率的独立预后因素(P<0.05).结论:术前外周血APRI值同接受根治性手术的HCC患者的预后密切相关,是其独立的预后因素.%Objective To explore the prognostic value of blood aspartate aminotransferase to platelet ratio index(APRI)in patients with hepatocellular carcinoma(HCC)after radical surgical resection. Methods A retro-spective cohort study was conducted to analyze 228 patients with HCC who underwent radical surgical resection. Patients were divided into low APRI group(APRI<1.62)and high APRI group(APRI≥1.62). Patients′clinical and demographic data and overall survival(OS)were statistically analyzed and multivariate analysis was performed to identify prognostic factors. Results APRI was closely related to preoperative serum ALT level,PLT level,the positivity of HBsAg,liver cirrhosis and portal vein tumor thrombus. OS of patients in low APRI group was signifi-cantly better when compared to those with an elevated APRI(P<0.01). Multivariate analysis indicated that preop-erative APRI,maximum size of tumor,number of tumor nodules,portal vein tumor thrombus,TNM and differenti-ation of tumors were independent prognostic factors for HCC(P<0.05). Conclusions Preoperative APRI≥1.62 is an independent prognostic factor of OS for patients with HCC after radical surgical resection.