Comparison Of Different Liver Function Evaluation Methods In Predicting Liver Injury After Tace For Advanced Hepatocellular Carcinoma

Objective: To compare the ability of different liver function scoring methods to predict liver function damage in patients with liver cancer after transarterial chemoembolization(TACE).Methods:This paper collected and analyzed the clinical data of 107 patients with advanced primary hepatocellular carcinoma(HCC)who met the exclusion criteria during the period from January 2018 to June2019 in interventional vascular surgery of our hospital,and analyzed the relevant factors affecting the severe liver function injury after TACE.The correlation among the four liver function scoring methods of child Pugh(CP),model for end-stage liver disease(MELD),albumin bilirubin(ALBI)scoring model and indocyanine green(ICG)clearance test was analyzed by speaman correlation.With the help of ROC curve,the accuracy of four liver function scoring methods in predicting liver function injury after TACE was compared,so as to make a better choice of operation scheme before TACE and strengthen preventive measures in time after TACE,reduce the risk of severe liver injury after TACE,and improve the prognosis of patients with liver cancer.Results:19 of 107 patients who met the exclusion criteria had severe liver function injury after TACE.Single factor analysis showed that albumin(ALB),total bilirubin(TBIL),aspartate aminotransferase(AST),alkaline phosphatase,ALP),TACE operation times,Child Pugh score and grade,ALBI score and grade,MELD score,ICG-R15 and ICG clearance test evaluation of liver function grade were all related to the occurrence of serious liver function injury after TACE(P < 0.05).The CP score was positively correlated with ALBI,MELD and ICG-R15(r > 0,P < 0.05).Areas under ROC curve(AUROC)of CP,ALBI,MELD and ICG clearance tests were 0.731(0.599~0.863)、0.765(0.645~0.885)、0.689(0.557~0.821)and 0.687(0.551~0.822),respectively.There was no significant difference between the areas under ROC curve of four liver function evaluation methods(P > 0.05).Conclusion:1.Albumin,total bilirubin,aspartic acid,alkaline phosphatase,number of TACE operations,Child Pugh score and its grade,ALBI score and its grade,MELD score,ICG-R15 and its evaluated liver function grade were all positively correlated with severe liver function injury after TACE operation;2.CP score was positively correlated with albi,MELD and ICG-R15,especially ALBI;3.the ability of four liver function evaluation methods to predict severe liver injury in patients with advanced liver cancer after TACE is basically the same.