Abstract

Objective

Albumin-to-alkaline phosphatase ratio (AAPR), a newly developed blood biomarker, has been reported to have prognostic value in several types of cancer. This study aimed to investigate the predictive value of AAPR in patients with early-stage hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA) as initial therapy.

Methods

This retrospective study analyzed 445 patients with newly diagnosed HCC undergoing RFA as initial therapy. A series of survival analyses were performed to evaluate the prognostic value of AAPR. Univariate and multivariate analyses were performed to identify independent prognostic factors. An AAPR-based nomogram was constructed, and its predictive performance was validated.

Results

Patients with a low AAPR had a significantly reduced recurrence-free survival (RFS) and overall survival (OS) compared with those with a high AAPR. AAPR was found to be an independent prognostic indicator and showed superior discrimination efficacy than other liver function indices. The AAPR-based nomogram had a concordance index value of 0.72 (95% confidence interval [CI]: 0.65–0.79) in the training cohort and 0.72 (95% CI: 0.63–0.81) in the validation cohort, which significantly outperformed other existing staging systems.

Conclusions

AAPR serves as a promising indicator of prognosis in patients with early-stage HCC undergoing RFA. The AAPR-based nomogram might contribute to individualized prognosis prediction and clinical decision making.

中文翻译：

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白蛋白与碱性磷酸酶的比值作为接受射频消融作为初始治疗的早期肝细胞癌患者肿瘤复发和预后的指标

摘要

目的

据报道，白蛋白与碱性磷酸酶的比率（AAPR）是一种新开发的血液生物标志物，在多种类型的癌症中具有预后价值。本研究旨在探讨AAPR在接受射频消融（RFA）作为初始治疗的早期肝细胞癌（HCC）患者中的预测价值。

方法

这项回顾性研究分析了445例接受RFA作为初始治疗的新诊断HCC患者。进行了一系列生存分析以评估AAPR的预后价值。进行单因素和多因素分析以鉴定独立的预后因素。构造了基于AAPR的列线图，并验证了其预测性能。

结果

与高AAPR的患者相比，低AAPR的患者的无复发生存（RFS）和总体生存（OS）明显降低。发现AAPR是独立的预后指标，并且显示出比其他肝功能指标更好的鉴别功效。基于AAPR的列线图在训练队列中的一致性指数值为0.72（95％置信区间[CI]：0.65-0.79），在验证队列中的一致性指数值为0.72（95％CI：0.63-0.81），显着优于其他现有模型舞台系统。

结论

AAPR可作为接受RFA的早期HCC患者的预后指标。基于AAPR的列线图可能有助于个性化的预后预测和临床决策。