Correlation Study Between Preoperative Serum Alkaline Phosphatase And Albumin Ratio(APAR) And Prognosis Of Hepatocellular Carcinoma After Radical Operation

Objective:To investigate the relationship between preoperative serum alkaline phosphatase(ALP)and albumin(Albumin,ALB)ratio(APAR)and prognosis after radical resection of hepatocellular carcinoma.Methods:A retrospective study was performed on 296 patients with hepatocellular carcinoma who were diagnosed by the hepatobiliary surgery of the Affiliated Hospital of North Sichuan Medical College from January 2015 to December 2019 and underwent radical surgery.Preoperative serum alkaline phosphatase and albumin ratio(APAR)was calculated,and the receiver operating characteristic curve(ROC)was used to divide patients into high APAR groups(APAR?3.38 U/g,136patients)and low APAR Group(APAR<3.38 U/g,160patients).Observe its distribution characteristics,compare the clinicopathological characteristics and disease-free survival rate of the two groups of patients,and use Cox univariate and multivariate analysis to screen independent risk factors that affect the tumor-free survival rate of patients with hepatocellular carcinoma(Hpatoceumar carcmoma,HCC).Results:The best boundary point of APAR is 3.38 U/g,the area under the curve is 72.1%,the sensitivity is 61.1%,and the specificity is 71.2%.Compared with the low APAR group,the tumor diameter of the high APAR group was larger;the levels of serum AST,ALT,and GGT were higher;the proportion of tumor invasion of large blood vessels,tumor recurrence,and advanced HCC were higher(all P<0.05).Patients in the high APAR group had significantly lower disease free survival(DFS)at 1,3,and 5 years after surgery than patients in the low AAR group(49.4%,20.0%,5.1%vs78.6%,42.7%,13.5%,P<0.05).Univariate analysis showed that APAR(U/g),BCLC staging,liver cirrhosis,large blood vessel invasion,maximum tumor diameter and number were the influencing factors for disease-free survival after surgery.Multivariate analysis showed that the maximum tumor diameter(cm),the number of tumors?3,the presence or absence of liver cirrhosis,BCLC stage,and APAR?3.38 U/g were independent risk factors for predicting tumor recurrence after surgery.Conclusions:Preoperative APAR is a simple,easy-to-detect,and low-cost indicator,and it is an independent prognostic factor for predicting tumor recurrence after liver resection in HCC patients.