Prognostic Analysis Of APAR,ALRI,ALR And Their Combination In Patients With Liver Cancer After TACE Surgery

Objective: To investigate the prognostic value of APAR,ALRI,ALR and their combination in patients with primary liver cancer after transcatheter arterial chemoembolization,and to provide reference for the clinical treatment of liver cancer.Methods: Clinical data of 124 patients diagnosed with liver cancer who received TACE treatment for the first time in the Affiliated Hospital of Youjiang Medical College for Nationalities from January 1,2017 to January 31,2022 were retrospectively analyzed.All cases were followed up to July 31,2022.General and clinical data of patients were collected.APAR,ALRI and ALR values were calculated according to preoperative serological indexes of patients,and the optimal critical values of APAR,ALRI and ALR were determined by ROC curve.Patients were divided into low APAR,ALRI and ALR group and high APAR,ALRI and ALR group according to the optimal critical values of APAR,ALRI and ALR group,and the relationship between the three groups of indicators and clinical characteristics was compared.Statistical software SPSS24.0 was used for statistical analysis.Counting data were tested by chi-square test.Survival data were analyzed by Kaplan-Meier method and tested by Log-Rank method,P<0.05 was considered statistically significant.After univariate analysis,P < 0.05 variables were included in Cox multifactor proportional risk regression model to determine independent survival predictors,P<0.05 was considered statistically significant.Results:(1)Of the 124 patients included in this study,38 survived,the longest survival time was 49 months,and the median survival time was 6 months.Six months after TACE,the survival rate is 50%.(2)ROC curve results showed that the optimal critical value of preoperative APAR was 3.04,the optimal critical value of preoperative ALRI was 71.35,and the optimal critical value of preoperative ALR was 59.19.(3)Preoperative clinical data of patients in the low APAR group and the high APAR group were compared.Statistically significant differences were found between different levels of APAR and GGT,ALT,AST,ALP,ALB,total bilirubin(TBi L),maximum tumor diameter,portal thrombus,tumor metastasis,Child-Pugh grade,multiple TACE treatment,TACE+ targeted drugs,ALRI and ALR(P < 0.05).Preoperative clinical data of patients in low ALRI group and high ALRI group were compared.It was found that there were statistically significant differences between different levels of ALRI and GGT,ALT,AST,ALP,ALB,AFP,total bilirubin(TBi L),hepatitis B,cirrhosis,portal thrombin,tumor metastasis,Child-Pugh grade,APAR and ALR(P < 0.05).Preoperative clinical data of patients in low ALR group and high ALR group were compared.Different levels of ALRs were found to be correlated with GGT,ALT,AST,ALP,ALB,total bilirubin(TBi L),prothrombin time(PT),cirrhosis,ascites,portal thrombin,tumor metastasis,maximum tumor diameter,Child Pug grade,multiple TACE treatments,TACE+targeted drugs,APAR,and ALRI The difference was statistically significant(P<0.05).(4)Kaplan-Meier method was used for univariate analysis of the general data of patients,and Log-Rank method was used for test.The results indicated that: Preoperative GGT,AST,ALP,ALB,AFP,total bilirubin(TBIL),ascites,portal thrombin,tumor metastasis,maximum tumor diameter,Child-Pugh grade,treatment,APAR,ALRI,and ALR were the risk factors for prognosis of patients with liver cancer after TACE surgery(P < 0.05).Meaningful variables(P<0.05)in the univariate analysis were included in Cox multifactor proportional risk regression model,and the results suggested that APAR(P=0.012),ALRI(P=0.027)and tumor metastasis(P=0.003)were independent risk factors for prognosis of HCC patients after TACE treatment.The ROC curve was plotted numerically by APAR combined with ALRI,APAR combined with ALR,and ALRI combined with ALR.It was found that the area under the curve drawn jointly was larger than that drawn separately by APAR,ALRI and ALR.After survival analysis,it was found that the combination of APAR,ALRI and ALR had a higher predictive value than the single prediction in predicting the prognosis of patients with liver cancer after TACE surgery.Conclusion:1.APAR,ALRI and ALR are risk factors affecting prognosis of liver cancer patients after TACE treatment.2.APAR,ALRI and tumor metastasis are independent risk factors for prognosis of HCC patients after TACE treatment.3.APAR combined with ALRI,APAR combined with ALR,and ALRI combined with ALR are risk factors for prognosis of patients with liver cancer after TACE treatment,and the combination of the two has a higher predictive value than a single indicator in predicting prognosis of patients with liver cancer.