| 摘要: |
| ［摘要］ 目的 探讨术前白蛋白-胆红素（ALBI）分级对肝门部胆管癌（HCCA）根治术后患者临床预后的预测价值。方法 回顾性分析2015年7月至2022年12月于昆明医科大学第二附属医院接受手术治疗的115例HCCA患者的临床资料。根据术前1周内的白蛋白和胆红素计算ALBI，按照ALBI分级系统（ALBI≤-2.60为1级，-2.60-1.39为3级）对HCCA患者进行分级，ALBI分级1级4例，2级91例，3级20例。比较术前ALBI分级1～2级组（由于ALBI分级1级的例数较少，将其与2级者合并为一组）和术前ALBI分级3级组HCCA患者的生存预后。采用Cox回归分析影响患者生存预后的因素。结果 术前ALBI分级1～2级组患者和术前ALBI分级3级组患者中位无病生存期（DFS）分别为23个月和10个月，两组DFS预后差异有统计学意义（P<0.05）；术前ALBI分级1～2级组患者和术前ALBI分级3级组患者中位总生存期（OS）分别为36个月和17个月，两组OS预后差异有统计学意义（P<0.05）。多因素Cox回归分析结果显示，术前ALBI分级为3级、有脉管癌栓以及美国癌症联合委员会（AJCC）的TNM分期为Ⅲ～Ⅳ期是影响HCCA患者术后DFS的独立危险因素（P<0.05），术前ALBI分级为3级以及AJCC的TNM分期为Ⅲ～Ⅳ期是影响HCCA患者术后OS的独立危险因素（P<0.05）。结论 术前ALBI分级对HCCA根治术后患者的预后具有预测价值。 |
| 关键词: 肝门部胆管癌 术前白蛋白-胆红素分级 根治性手术 预后 预测 |
| DOI：10.3969/j.issn.1674-3806.2025.09.04 |
| 分类号:R 735.8 |
| 基金项目:国家自然科学基金项目（编号：82460461）；云南省科技厅科技计划项目（编号：202205AC160063，202401AW070003）；云南省教育厅科学研究基金项目（编号：2025J325） |
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| Study on the value of preoperative albumin-bilirubin grade in predicting patients′ clinical prognosis after radical resection of hilar cholangiocarcinoma |
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QIAN Chunhang, GENG Qin, KANG Qiang, LI Jing, YANG Chen, KE Yang, LI Yuehua
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The Second Ward of Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China
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| Abstract: |
| ［Abstract］ Objective To explore the value of preoperative albumin-bilirubin(ALBI) grade in predicting patients′ clinical prognosis after radical resection of hilar cholangiocarcinoma(HCCA). Methods The clinical data of 115 patients with HCCA who underwent surgical treatment in the Second Affiliated Hospital of Kunming Medical University from July 2015 to December 2022 were retrospectively analyzed. The ALBI was calculated based on the albumin and bilirubin values of the HCCA patients within 1 week before the operation. According to the ALBI grading system(ALBI≤-2.60 as grade 1, -2.60-1.39 as grade 3), the HCCA patients were graded, including 4 patients with ALBI grade 1, 91 patients with ALBI grade 2 and 20 patients with ALBI grade 3. The survival prognosis of the HCCA patients in the preoperative ALBI grade 1-2 group(Due to the small number of patients with ALBI grade 1, the patients with ALBI grade 1 and those with ALBI grade 2 were combined into one group) and the preoperative ALBI grade 3 group was compared. The factors affecting the survival prognosis of the patients were analyzed by using Cox regression. Results The median disease-free survival(DFS) of the patients in the preoperative ALBI grade 1-2 group and the preoperative ALBI grade 3 group was 23 months and 10 months, respectively, with statistically significant difference in prognosis of DFS between the two groups(P<0.05), and their median overall survival(OS) was 36 months and 17 months, respectively, with statistically significant difference in prognosis of OS between the two groups(P<0.05). The results of multivariate Cox regression analysis showed that preoperative ALBI grade 3, vascular carcinoma embolus and American Joint Committee on Cancer(AJCC) stages(TNM stages) Ⅲ and Ⅳ were independent risk factors for DFS in the HCCA patients after operation(P<0.05), and preoperative ALBI grade 3, AJCC stages(TNM stages) Ⅲ and Ⅳ were independent risk factors for OS in the HCCA patients after operation(P<0.05). Conclusion Preoperative ALBI grade has predictive value for the prognosis of HCCA patients after radical resection of HCCA. |
| Key words: Hilar cholangiocarcinoma(HCCA) Preoperative albumin-bilirubin(ALBI) grade Radical surgery Prognosis Prediction |
