[1]孙 玉,张洪海,生守鹏,等.白蛋白-胆红素分级在早期肝细胞癌射频消融中的预后意义 [J].介入放射学杂志,2021,30(05):502-507.
　SUN Yu,ZHANG Honghai,SHENG Shoupeng,et al.Prognostic significance of albumin-bilirubin grading in patients with early hepatocellular carcinoma after radiofrequency ablation treatment[J].journal interventional radiology,2021,30(05):502-507.
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白蛋白-胆红素分级在早期肝细胞癌射频消融中的预后意义
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年05
页码:
502-507
栏目:
临床研究
出版日期:
2021-05-25

文章信息/Info

Title:
Prognostic significance of albumin-bilirubin grading in patients with early hepatocellular carcinoma after radiofrequency ablation treatment
作者:
孙 玉;  张洪海;  生守鹏;  袁春旺;  崔石昌;  郑加生;  张永宏
Author(s):
SUN Yu;  ZHANG Honghai;  SHENG Shoupeng;  YUAN Chunwang; CUI Shichang;  ZHENG Jiasheng;  ZHANG Yonghong.
Minimally-Invasive Interventional Center of Oncology，Affiliated Beijing You’an Hospital， Capital Medical University， Beijing 100069，China
关键词:
【关键词】 癌; 肝细胞;  射频消融;  白蛋白-胆红素分级;  预后
文献标志码:
A
摘要:
【摘要】 目的 探讨白蛋白- 胆红素（ALBI）分级在接受肝动脉栓塞（TAE）联合射频消融（RFA）治疗的早期HCC患者中预后的意义。方法 选择2006年4月至2010年12月接受TAE联合RFA治疗的HCC患者215例。定期随访，收集患者临床资料数据，Kaplan- Meier法绘制生存曲线，log- rank检验比较生存率，总生存期和无瘤生存期影响因素的单因素及多因素分析采用Cox回归分析。结果 中位随访时间109个月，死亡100例，生存115例，1、2、3、5和10年生存率分别为99.5%、96.7%、92.1%、74%、57.6%。复发165例，1、2、3、5和10年复发率分别22.4%、39.3%、54.2%、69.7%、81.1%。ALBI 1级组患者生存率明显高于2级组患者，差异有显著统计学意义（χ2=9.07，P＜0.01）。Cox多因素预后分析显示，年龄、ALBI分级、肿瘤直径是早期HCC患者消融术后长期生存的独立影响因素（P＜0.05）。肿瘤直径是早期肝细胞癌患者消融术后无瘤生存期的独立影响因素（P＜0.05）。结论 ALBI分级、年龄、肿瘤直径是影响早期HCC RFA术后总生存期的独立危险因素，肿瘤直径是影响无瘤生存期的独立危险因素。

参考文献/References:

［1］ Bray F， Ferlay J， Soerjomataram I， et al. Global cancer statistics 2018： GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA Cancer J Clin， 2018， 68： 394- 424.
［2］ Hung HH， Chiou YY， Hsia CY， et al. Survival rates are comparable after radiofrequency ablation or surgery in patients with small hepatocellular carcinomas［J］. Clin Gastroenterol Hepatol， 2011， 9： 79- 86.
［3］ Johnson PJ， Berhane S， Kagebayashi C， et al. Assessment of liver function in patients with hepatocellular carcinoma： a new evidence- based approach：the ALBI grade［J］. J Clin Oncol， 2015， 33： 550- 558.
［4］ Pinato DJ， Sharma R， Allara E， et al. The ALBI grade provides objective hepatic reserve estimation across each BCLC stage of hepatocellular carcinoma［J］. J Hepatol， 2017， 66： 338- 346.
［5］ 中华人民共和国国家卫生和计划生育委员会． 原发性肝癌诊疗规范（2017年版）［J］． 传染病信息， 2017， 30：111- 127．
［6］ 姚红响，陈根生，诸葛英，等． 肝动脉化疗栓塞联合CT引导射频消融序贯治疗中小肝癌的临床应用［J］． 介入放射学杂志，2012， 21：301- 304．
［7］ Gui CH， Baey S， D’cruz RT， et al. Trans- arterial chemoembo-lization?+ radiofrequency ablation versus surgical resection in hepatocellular carcinoma ：a meta- analysis［J］. Eur J Surg Oncol， 2020， 46：763- 771.
［8］ Masatoshi K， Izumi N， Sakamoto M， et al. Survival analysis over 28 years of 173，378 patients with hepatocellular carcinoma in Japan［J］. Liver Cancer， 2016， 5： 190- 197.
［9］ Hiraoka A， Kumada T， Masatoshi K， et al. Albumin- bilirubin （ALBI） grade as part of the evidence- based clinical practice guideline for HCC of the Japan Society of Hepatology：a comparison with the liver damage and Child- Pugh classifi- cations［J］. Liver Cancer， 2017， 6： 204- 215.
［10］ Kim YS， Lim HK， Rhim H， et al. Ablation of hepatocellular carcinoma［J］. Best Pract Res Clin Gastroenterol， 2014， 28： 897- 908.
［11］ Bruix J， Reig M， Sherman M. Evidence- based diagnosis， staging， and treatment of patients with hepatocellular carcinoma［J］. Gastroenterology， 2016， 150： 835- 853.
［12］ Yau T， Tang VY， Yao TJ， et al. Development of Hong Kong liver cancer staging system with treatment stratification for patients with hepatocellular carcinoma［J］. Gastroenterology， 2014， 146： 1691- 1700.
［13］ Masatoshi K， Trevisani F， Abou- Alfa GK， et al. Hepatocellular carcinoma：therapeutic guidelines and medical treatment［J］. Liver Cancer， 2017， 6： 16- 26.
［14］ 张争运，张国梁，万 霖，等． ALBI分级对反复行TACE治疗肝细胞癌患者预后评估的价值［J］． 肿瘤， 2019， 39： 722- 729．
［15］ Zou H， Yang X， Li QL， et al. A comparative study of albumin- bilirubin score with Child- Pugh score， model for end- stage liver disease score and indocyanine green R15 in predicting posthepa- tectomy liver failure for hepatocellular carcinoma patients［J］. Dig Dis， 2018， 36： 236- 243.
［16］ Oh IS， Sinn DH， Kang TW， et al. Liver function assessment using albumin- bilirubin grade for patients with very early- stage hepatocellular carcinoma treated with radiofrequency ablation［J］. Dig Dis Sci， 2017， 62： 3235- 3242.
［17］ Chen PC， Chiu NC， Su CW， et al. Albumin- bilirubin grade may determine the outcomes of patients with very early stage hepatocellular carcinoma after radiofrequency ablation therapy［J］. J Chin Med Assoc， 2019， 82： 2- 10.
［18］ Bag rsakci E， Sahin E， Atabey N， et al. Role of albumin in growth inhibition in hepatocellular carcinoma［J］. Oncology， 2017， 93： 136- 142.
［19］ Shim JH， Jun MJ， Han S， et al. Prognostic nomograms for prediction of recurrence and survival after curative liver resection for hepatocellular carcinoma［J］. Ann Surg， 2015， 261： 939- 946.
［20］ Du ZG， Wei YG， Chen KF， et al. Risk factors associated with early and late recurrence after curative resection of hepatocellular carcinoma： a single institution’s experience with 398 consecutive patients［J］. Hepatobiliary Pancreat Dis Int， 2014， 13： 153- 161.
［21］ Albillos A， Lario M， Alvarez- Mon M. Cirrhosis- associated immune dysfunction： distinctive features and clinical relevance［J］. J Hepatol， 2014， 61： 1385- 1396.
［22］ Ma S， Ding M， Li J， et al. Ultrasound- guided percutaneous microwave ablation for hepatocellular carcinoma： clinical outcomes and prognostic factors［J］. J Cancer Res Clin Oncol， 2017， 143： 131- 142.

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备注/Memo

备注/Memo:
（收稿日期：2020- 02- 19）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2021-05-20