The Value Of PA Content Preoperative In Prognosis Of HCC Patients Postoperative

Background&Aims:Hepatocellular carcinoma(HCC)is the sixth most prevalent malignant tumor in the world.With the widespread spread of hepatitis B virus,the incidence of cancer has increased year by year.At present,the treatment strategy for primary liver cancer is mainly surgical treatment,liver transplantation and percutaneous liver therapy,these all have good effects,?However,liver resection is currently the most internationally recognized the most appropriate treatment.Liver function as a major factor affecting the ability of patients with liver cancer surgery,in the preoperative assessment is particularly important.Previous studies have shown that liver function in patients undergoing liver resection is Child-A or Early Child-B.But some have been evaluated that patients who are eligible for surgery do not achieve the desired outcome after receiving hepatectomy.To the end,we work to explore a number of patients may affect the long-term prognosis of preoperative liver indicators.After statistical and analysis,we found that preoperative serum prealbumin serum and patients with long-term survival is closely related.Prealbumin(PA)is a kind of plasma protein synthesized by hepatocytes,which is affected only by the metabolism of hepatocytes.Its concentration is not changed by intravenous supplementation of plasma products.Compared with other indexes(PT,TB,ALB)in assessing liver function,More reliable.Previous studies suggest that prealbumin content is the most appropriate indicator of liver function.Therefore,this study mainly used a single multi-factor and survival analysis to explore preoperative plasma prealbumin content and liver resection of patients with hepatocellular carcinoma in patients with long-term prognosis.Methods:The study included 373 cases of preoperative diagnosis of primary liver cancer and postoperative pathology confirmed as primary liver cancer patients.All patients were tested for liver function before operation,and serological parameters were monitored on the 1st,3rd and 5th day after operation.The patients were examined for postoperative complications,postoperative pathological results and clinical status.Monthly follow-up once,the second year of every 3 months follow-up once,the third year and thereafter every six months follow-up.The main record of patients with tumor recurrence and survival status.Logistic regression analysis was used to analyze the relationship between preoperative serum liver function and postoperative complications.Univariate analysis was used to analyze the influencing factors of long-term prognosis in patients with preoperative serum liver function.Multivariate analysis of influencing single factor,The independent risk factors associated with the patient's long-term prognosis were obtained and the diagnostic model(PA)was constructed according to the independent risk factors.The ROC curve of the subjects was used to understand the diagnostic efficacy.Results:373 patients underwent single and multivariate Cox analysis and found that t umor size(HR:3.021;95%CI:1.465-6.277),TNM(HR:1.602;95%CI:1.355-1.895),PA concentration(HR = 0.689,P = 0.034).Vascular invasion(HR:1.711;95%CI:1.064-2.753)was an independent risk factor for the total survival time of patients.The median survival time was 32.3 months,TNM(HR:1.489;95%CI:1.284-1.725),pre albumin concentration(HR:0.639;95%CI:0.482-0.846),vascularinvasion(HR:1.54;95%CI:1.004-2,360)was an independent risk factor for postoperative recurrenc e Time is 20.5 months.Patients with preoperative albumin levels above 152 g / ml had a significantly better prognosis than those with preoperative albumin levels below 152 g / ml,with significant statistical differences.Conclusions:In this study,the relationship between serum pre albumin and overall prognosis of patients was studied by various statistical methods.It was found that patients with low albumin content before operation had high incidence of postoperative complications and poor long-term prognosis.This study confirms that preoperative low albumin content is an independent risk factor for overall prognosis of hepatocellular carcinoma patients undergoing hepatectomy.