Objective:To evaluate the judgment value of preoperative ALBI grade combined with APRI on the prognosis of patients with hepatocellular carcinoma after hepatectomy.Methods:The medical records of 156 patients who were diagnosed with primary liver cancer and underwent radical resection of liver cancer from January 2014 to December 2018 in the Department of Hepatobiliary Surgery,Chifeng Clinical School of Medicine,Inner Mongolia Medical University were collected and retrospectively analyzed.Until December 31,2021.After comparing the following groups: survival group-death group,recurrence-free survival group-recurrence or death group Clinical medical records,the risk factors related to postoperative prognosis of patients with hepatocellular carcinoma were determined,and univariate COX analysis was performed on the relevant risk factors.Then,single factor with P<0.05 was selected and incorporated into COX proportional hazards model for multivariate analysis.The Receiver Operating Characteristic/sensitivity curve(ROC)was used to determine the APRI cut-off value of0.37,assigning APRI≤0.37=0 and APRI>0.37=1,and grading the preoperative ALBI to0 points for ALBI grade 1,1 point for ALBI grade 2.ALBI-APRI score is obtained by adding ALBI and APRI scores,according to this standard,it can be divided into three groups,namely low-risk group(assigned 0 point),intermediate-risk group(Assign 1point),high-risk group(assign 2 points).The Kaplan-Meier curve was used to evaluate the differences in postoperative prognosis of patients with hepatocellular carcinoma in different groups of ALBI grade,APRI,and ALBI-APRI score.Finally,the ROC curves of ALBl grade,APRI,and ALBI-APRI were drawn respectively,and the area under the ROC curve(AUC)was calculated to compare their prediction effects.P<0.05 was considered to be statistically significant.Results:1.Univariate analysis revealed that ALBI-APRI(P=0.002),tumor diameter grouping(P=0.001),degree of HCC pathological differentiation(P=0.000),microvascular invasion(P=0.0001),BCLC stage(P=0.000),TNM stage(P=0.022),CA199(P=0.003),albumin(P=0.012)were correlated with postoperative overall survival of HCC,Multivariate analysis showed that among them,ALBI-APRI score(P=0.013),degree of pathological differentiation(P=0.009)and CA199(P=0.010)were independent predictors of postoperative overall survival.2.Univariate analysis revealed that ALBI-APRI(P=0.002),degree of HCC pathological differentiation(P=0.000),microvascular invasion(P=0.002),CA199(P=0.004)were correlated with postoperative recurrence-free survival of HCC,Multivariate analysis showed that among which the ALBI-APRI score(P=0.002),degree of HCC pathological differentiation(P=0.018),microvascular invasion(P=0.036),and CA199(P=0.016)were independent predictors of postoperative recurrence-free survival.3.Judging from the Kaplan-Meier survival curve:(1).The overall survival and recurrence-free survival of HCC patients in grade ALBI 2 group were significantly lower than in grade ALBI 1 group,and the overall survival rates in 1 and 3 year were 67.0% 、 86.6% and 45.8% 、 71.2%,respectively,and were statistically significant(P=0.004).The 1-and 3-year recurrence-free survival rates were 64.5%、66.7% and 40.8%、55.6%,respectively,and were statistically significant(P=0.002).(2).Both overall and recurrence-free survival in the low APRI group were significantly higher than in the high APRI group.1-and 3-year Overall survival rates were 87.8%,80.4% and 69.4%,54.2%,respectively,(P=0.038).1-and 3-year recurrence-free survival rates were 66.7%,64.5% and 57.6%,40.8%,respectively,(P=0.029).The differences were all statistically significant.(3).There were significant differences in overall and recurrence-free survival between the ALBI-APRI three groups(P=0.004 and 0.002,respectively).Group A had the best prognosis,followed by group B and the worst in group C.one-year and 3-year overall survival rates were(94.4%,75.0%),(80.0%,61.3%),(71.1%,42.23%),and one-year and three-year recurrence-free survival rates were(71.2%,68.1%),(63.8%,51.0%),(42.2%,29.2%).4.Draw and calculate the Areaunder the Curve(AUC)of the ALBI-APRI,ALBl,APRI overall survival was 0.639,0.614,0.579,respectively,and the AUCof the recurrence-free survival was 0.638,0.572,0.619,respectively,Both ALBI-APRI had the maximum area under the curve,indicating that ALBI-APRI scores were better predictive of postoperative outcome than that of ALBI or APRI used alone.Conclusion:1.The ALBI-APRI score,the degree of tumor pathological differentiation,MVI,and CA199 were the independent predictors of the postoperative prognosis of HCC.2.Preoperative ALBl grade,APRI,and ALBI-APRI can all predict the prognosis of patients with hepatocellular carcinoma after hepatectomy,and have the advantages of noninvasive,easy access and objective.3.The predictive efficiency of ALBI-APRI score is better than that of ALBI or APRI used alone,indicating that it is feasible to jointly predict using by multiple risk factors,and the joint method can be explored from multiple angles to improve the predictive efficiency in the future. |