Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function

被引：265

作者：

Hiraoka, Atsushi ^{[1
]}

Michitaka, Kojiro ^{[1
]}

Kumada, Takashi ^{[2
]}

Izumi, Namiki ^{[3
]}

Kadoya, Masumi ^{[4
]}

Kokudo, Norihiro ^{[5
]}

Kubo, Shoji ^{[6
]}

Matsuyama, Yutaka ^{[7
]}

Nakashima, Osamu ^{[8
]}

Sakamoto, Michiie ^{[9
]}

Takayama, Tadatoshi ^{[10
]}

Kokudo, Takashi ^{[11
]}

Kashiwabara, Kosuke ^{[12
]}

Kudo, Masatoshi ^{[13
]}

机构：

[1] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, 83 Kasuga Cho, Matsuyama, Ehime 7900024, Japan

[2] Ogaki Municipal Hosp, Dept Gastroenterol, Ogaki, Japan

[3] Musashino Red Cross Hosp, Dept Gastroenterol, Tokyo, Japan

[4] Shinshu Univ, Sch Med, Dept Radiol, Matsumoto, Nagano, Japan

[5] Natl Ctr Global Hlth & Med, Tokyo, Japan

[6] Osaka City Univ, Grad Sch Med, Dept Hepatobiliary Pancreat Surg, Osaka, Japan

[7] Univ Tokyo, Sch Publ Hlth, Dept Biostat, Tokyo, Japan

[8] Kurume Univ Hosp, Dept Clin Lab Med, Kurume, Fukuoka, Japan

[9] Keio Univ, Sch Med, Dept Pathol, Keio, Japan

[10] Nihon Univ, Sch Med, Dept Digest Surg, Tokyo, Japan

[11] Grad Sch Med, Dept Surg, Hepatobiliary Pancreat Surg Div, Tokyo, Japan

[12] Univ Tokyo, Grad Sch Med, Sch Publ Hlth, Dept Biostat, Tokyo, Japan

[13] Kindai Univ, Sch Med, Dept Gastroenterol & Hepatol, Osaka, Japan

来源：

LIVER CANCER | 2017年 / 6卷 / 04期

关键词：

Hepatocellular carcinoma; Albumin-bilirubin grade; TNM stage; Japan Integrated Staging; Prognosis; Modified albumin-bilirubin grade; CONTRAST-ENHANCED ULTRASONOGRAPHY; INTEGRATED STAGING SCORE; RADIOFREQUENCY ABLATION; ELDERLY-PATIENTS; LIVER-FUNCTION; SYSTEM; PROGNOSIS; THERAPY; CANCER; HEPATOLOGY;

D O I：

10.1159/000479984

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background/Aim: Recently, albumin-bilirubin (ALBI) scoring/grading, consisting of only albumin and total bilirubin, has been proposed. We examined the efficacy of this grading system for determining hepatic function in patients with hepatocellular carcinoma (HCC). Methods/Materials: The prognoses of 46,681 HCC patients based on results obtained from a nationwide survey conducted in Japan from 2001 to 2007 were evaluated using (1) Japan Integrated Staging (JIS), consisting of Child-Pugh classification and TNM staging (TNM), (2) modified JIS (m-JIS), consisting of liver damage grading and TNM, and (3) ALBI-TNM (ALBI-T), consisting of ALBI grading and TNM, and the results were compared. A subanalysis was also performed to define a cutoff value for ALBI scores for a more detailed stratification of hepatic function. Results: ALBI-T, JIS, and m-JIS each showed good capacity for the stratification of prognoses. Although the Akaike information criterion for ALBI-T was nearly equal to that for JIS and m-JIS, the Kaplan-Meier curves and median survival times obtained with ALBI-T were always superior to the corresponding scores. When the indocyanine green retention test (<30%) was used as an additional cutoff value for ALBI score (-2.270, area under the curve 0.828) to divide ALBI grade into 4 levels (modified ALBI [mALBI] grade), mALBI grade was able to stratify the prognosis of patients at any TNM stage in order of grade. Modified ALBI-T (mALBI-T), using mALBI grading and TNM, produced a more detailed stratification for prognosis. Conclusion: The predictive value for prognosis of ALBI-T was found to be equal to that of JIS and m-JIS. In addition, mALBI grading and mALBI-T, as proposed in the present study, might provide a more detailed assessment of the hepatic function and prognosis of HCC patients. (C) 2017 S. Karger AG, Basel

引用

页码：325 / 336

页数：12

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