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Updated: Aug 29, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Albumin-Bilirubin Grade, Tumor Characteristics, and Survival of Patients with Hepatocellular Carcinoma
Rossella Donghia1, Brian Irving Carr2
1Data Science Unit, National Institute of Gastroenterology - IRCCS "Saverio de Bellis", Bari, Italy.
Introduction:
Albumin-bilirubin (ALBI) grade has recently been introduced as an objective measure of liver function and has been shown to be useful in prognostication for patients with hepatocellular carcinoma (HCC). The reasons for this usefulness in HCC prognostication are not clear.
Methods:
The study aimed to determine, in HCC patients, whether ALBI grade correlates with indices of HCC aggressiveness. A large cohort of nonsurgical HCC patients was examined for ALBI grade in relation to maximum tumor diameter (MTD), tumor focality, percentage of patients with portal vein thrombosis (PVT), serum alpha-fetoprotein (AFP) levels and survival.
Results:
ALBI grade was significantly associated with HCC aggressiveness parameters, particularly AFP, PVT, and tumor multifocality, but not with MTD. Similar associations were observed in the subset of patients with low AFP levels. ALBI grade showed a strong and graded relationship with survival, comparable to that observed for serum albumin alone. In Cox models stratified by ALBI categories, AFP, PVT, and tumor multifocality were independently associated with mortality.
Conclusions:
These findings suggest that ALBI reflects not only liver function, but also correlates with tumor aggressiveness features.
