Analysis Of The Correlation Between ALBI Score Combined With Serum CA125,CA199 And Bone Metastasis In HCC

[Objective] The purpose of this study was to analyze the risk factors for bone metastasis in patients with hepatocellular carcinoma(HCC),exploring the correlation between serum ALBI scores,CA125,CA199 and bone metastasis in HCC,and evaluate the value of various indicators in the early diagnosis and follow-up monitoring of bone metastasis in HCC.[Methods] This study included 154 patients with HCC accompanied by extrahepatic metastasis were admitted to the The Second Affiliated Hospital of Kunming Medical University from January 2015 to December 2022.Based on the results of SPECT bone imaging combined with CT and MRI,patients were divided into HCC bonemetastasis group and non-bone-metastasis group,with 63 cases in the HCC bone metastasis group and 91 cases in the non bone metastasis group.The age,sex,history of hepatitis B,bone metastasis site,number of intrahepatic lesions,maximum diameter of primary focus and preoperative serological indicators(ALB,TBil,ALBI score,CA125,CA199,CA153,CEA,AFP)of the two groups of patients were collected.First,the above indicators were analyzed by single factor analysis,then the statistically significant indicators in the single factor analysis were tested by collinearity test,and finally the non collinearity indicators were analyzed by multi factor logistic regression,To determine independent risk factors for bone metastasis in HCC.The value of independent risk factors in predicting bone metastasis in HCC was analyzed by plotting ROC curves.R4.2.2 was used to establish a risk profile model for predicting bone metastasis in HCC,and the clinical application value of the model was evaluated by drawing calibration curves and decision curves.[Results] 1.The ALB,TBil,ALBI score,CA125,CA199,CA153,CEA,AFP,age,and the number of intrahepatic lesions(single /multiple)were statistically significant(P<0.05)between the HCC bone metastasis group and the non bone metastasis group,while the gender,hepatitis B history(with /without),and the maximum tumor diameter(<58mm,≥58mm)were not statistically significant(P>0.05)between the two groups.ALB,Tbil,and the number of intrahepatic lesions were co linear with the ALBI score.Multivariate logistic regression analysis showed that ALBI score,CA125,and CA199 were independent risk factors for bone metastasis in HCC(P<0.001).2.The results of ROC curve analysis showed that the AUC values of ALBI score,CA125,and CA199 in the diagnosis of bone metastasis in HCC were 0.743,0.757,and 0.732;The sensitivity was 68.9%,73.0%,55.6%,and the specificity was 73.6%,70.3%,and 87.9%,respectively.The ALBI score≥-2.2,CA125≥26.815 U /L,CA199≥81.79 U /L are the optimal threshold values for diagnosing bone metastasis in HCC.The AUC value for diagnosing bone metastasis in HCC when combined with multiple indicators(ALBI score+CA125+CA199)was 0.854(>0.85).3.Based on ALBI scores,CA125,and CA199,a nomograph model for predicting bone metastasis in HCC was constructed,with a calibration curve that was approximately the same as the ideal curve.The decision curve results show that when the threshold probability is within 0.18-0.94,the corresponding net income is higher than the net income of diagnosing BM for all and not diagnosing BM for all.[Conclusion] 1.ALBI score,CA199,and CA125 are independent risk factors for bone metastasis in HCC.When the ALBI score is ≥-2.2,CA125≥26.815 U /L,CA199≥81.79 U /L,the probability of bone metastasis in HCC patients is higher.2.The combination of ALBI score,CA199,and CA125 has better diagnostic efficacy for HCC bone metastases,and is superior to a single indicator for the diagnosis of HCC bone metastases.3.The simple prediction model for bone metastasis in HCC based on ALBI score,CA125,and CA199 has good calibration ability and clinical application value,and can effectively predict the risk of bone metastasis in HCC patients.