开发和验证基于六个参数的实验室预后模型 (APHPBA分数),用于为乙型肝炎病毒相关的肝细胞癌进行肝切除术的患者
Yi-Fei Liu1, Hong Wang2, Ya-Hao Zhou3
1Department of General Surgery, The First Affiliated Hospital of Henan University, Kaifeng, Henan, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
概括
使用常规实验室测试的新APHPBA评分为手术后患有乙型肝炎病毒相关肝细胞癌 (HBV-HCC) 的患者提供了更好的风险分层. 这一分数在预测患者结果的现有方法上得到了改善.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 生物化学 生物化学
背景情况:
- 与乙型肝炎病毒 (HBV) 相关的肝细胞癌 (HCC) 呈现出显著的预后变异性,目前的分期系统没有充分解决这一问题.
- 准确的风险分层对于优化HBV-HCC治疗策略和患者管理至关重要.
研究的目的:
- 开发和验证APHPBA评分,一种新的基于实验室的预后模型,用于为HBV相关的HCC进行治疗性肝切除术的患者.
- 评估APHPBA评分的表现与已建立的分阶段系统相比.
主要方法:
- 一项多中心的回顾性研究,涉及1100名因HBV相关的HCC而接受肝切除术的患者 (2018-2023).
- APHPBA评分来自六个手术前实验室参数:α-fetoprotein (AFP),由维生素K缺失引起的蛋白质-II (PIVKA-II),HBV-DNA,前热血素时间 (PT),胆红素 (BIL) 和白蛋白 (ALB).
- 根据APHPBA得分,患者被分为三个阶段 (I-III),使用考克斯回归和时间依赖ROC分析评估预后表现.
主要成果:
- APHPBA评分显示出显著的预后价值,五年整体生存率为63.4% (第一阶段),43.3% (第二阶段) 和26.4% (第三阶段) (P < 0.001).
- 在对临床病理因素进行调整后,得分仍然是整体生存的独立预测指标.
- APHPBA评分始终优于传统分阶段系统的表现,由更高的依赖时间的AUCs证明.
结论:
- APHPBA评分提供了一种强大而可靠的方法,用于在HBV相关的HCC中进行术后风险分层.
- 它依赖于常规可用的实验室参数,使其成为临床应用的实际工具.
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