| Objective To assess the prognostic value of aspartate aminotransferase to lymphocyte ratio index(ALRI)on the patients with hepatocellular carcinoma after receiving transarterial chemoembolization(TACE).Methods The preoperative clinical data of 78 patients with liver cancer were collected.The biochemical and blood routines of the patients were collected before operation.The AST and L index values of the patients were calculated to obtain preoperative ALRI.The patients were followed up for progression-free survival after TACE.Period(PFS)and overall survival(0S),the ROC curve was drawn to determine the critical value.According to the critical value,the patients were divided into two groups with ALRI greater than the critical value and ALRI less than or equal to the critical value.The data were analyzed by Kaplan-Meier method.The PFS and 0S of the two groups were determined separately,and the difference was statistically significant.Univariate and multivariate survival analyses were performed in patients with liver cancer using Kaplan-Meier and Cox regression models to determine independent predictors of PFS and OS.Results Among 78 patients with liver cancer,67 males(85.9%)and 11 females(14.1%)had an age distribution of 44-71 years,with an average age of 60.12 years,and 64 cases(82.1%)positive for hepatitis B surface antigen(HBs Ag);53 cases(67.9%)were hardened;28 cases(35.9%)were AFP?400 ng/m1;the average maximumdiameter of tumor was 6.9cm(1.6~18.0 cm),of which 51 cases(65.4%)were >5 cm in diameter,and There were 58 patients(74.4%)with a single tumor and 59 patients(75.6%)died during the 5-year follow-up period.There were 41 patients(52.6%)with stage B BCLC and 37 patients(47.4%)with stage C.When ALRI at 22.82,the predicted survival state featured highest sensitivity and specificity,including 58 cases(74.4%)with ALRI>22.82 and 20 cases(25.6%)with ALRI?22.82.preoperative ALRI and tumor size(?2=10.971,p=0.001),hepatitis B surface antigen(?2=5.310,p=0.021),cirrhosis No(?2=9.647,p=0.002)Barcelona(BCLC)stage(?2=19.425,p<0.001)and portal vein tumor thrombus(?2=6.590,p=0.010)were correlated.Kaplan-Meier survival analysis showed that the mean OS time of liver cancer patients with preoperative ALRI > 22.82 was 18.16 months,which was significantly shorter than preoperative ALRI ? 22.82(41.65 months)(p = 0.001)(Fig.2).The mean PFS time of the preoperative ALRI>22.82 group was 15.52 months,which was significantly shorter than the preoperative ALRI?22.82 group(38.55 months)(p=0.001).Univariate analysis showed preoperative ALRI(p=0.001),tumor number(p=0.002),AFP(p=0.025),BCLC stage(p<0.001),tumor size(p<0.006),distant metastasis(p < 0.001),portal vein tumor thrombus(p < 0.001)and PFS in patients with liver cancer after TACE.Preoperative ALRI(p=0.001),tumor number(p<0.001),AFP(p=0.018),BCLC stage(p<0.001),tumor size(p<0.010),distant metastasis(p<0.001),Portal vein tumor thrombus(p=0.001)was associated with OS after TACE in patients with liver cancer.Cox regression model analysis showed preoperative ALRI(HR,2.212;95% CI,1.039 to 4.711;p=0.040),portal vein tumor thrombus(HR,2.954;95% CI,1.654 to 5.276;p < 0.001)is TACE for liver cancer patients Postoperative PFS significantly independent influencing factors,and preoperative ALRI(HR,2.269;95% CI,1.017 to 5.060;p = 0.045),portal vein tumor thrombus(HR,2.788;95% CI,1.510 to 5.149;p = 0.001 The tumor size(HR,2.498;95% CI,1.182-8.276;p=0.016)was a significant independent factor for OS in patients with liver cancer after TACE.Conclusion The pre-operation ALRI can be the independent factor used to predict the prognosis of patients with hepatocellular carcinoma after TACE treatment.A lower ALRI value of patients with hepatocellular carcinoma before TACE often indicates a good prognosis.In clinical work,we should not only pay attention to the pathological condition and clinical stage of liver cancer patients,but also pay attention to the biochemical and immune indicators of patients,so as to better evaluate the prognosis of patients. |
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