Résumé
Objective:To construct a nomogram prediction model for survival after radical surgical resection of intrahepatic cholangiocarcinoma (ICC) based on the albumin-bilirubin index (ALBI), and to evaluate its predictive efficacy.Methods:From January 2016 to January 2020, 170 patients with ICC who underwent radical surgical resection at the People's Hospital of Zhengzhou University were retrospectively analyzed. There were 90 males and 80 females, aged (58.5±10.6) years old. Based on a ratio of 7∶3 by the random number table, the patients were divided into the training set ( n=117) and the internal validation set ( n=53). The training set was used for nomogram model construction, and the validation set was used for model validation and evaluation. Follow up was conducted through outpatient reexamination and telephone contact. The Kaplan-Meier method was used for survival analysis, and a nomogram was drawn based on variables with a P<0.05 in multivariate Cox regression analysis. The predictive strength of the predictive model was evaluated by analyzing the consistency index (C-index), calibration curve, and clinical decision curve of the training and validation sets. Results:Multivariate Cox regression analysis showed that carbohydrate antigen 19-9 (CA19-9) ≥37 U/ml ( HR=1.99, 95% CI: 1.10-3.60, P=0.024), ALBI≥-2.80 ( HR=2.43, 95% CI: 1.40-4.22, P=0.002), vascular tumor thrombus ( HR=2.34, 95% CI: 1.40-3.92, P=0.001), and the 8th edition AJCC N1 staging ( HR=2.18, 95% CI: 1.21-3.95, P=0.010) were independent risk factors affecting postoperative survival of ICC patients after curative resection. The predictive model constructed based on the above variables was then evaluated, and the C-index of the model was 0.76. Calibration curve showed the predicted survival curve of ICC patients at 3 years after surgery based on the model was well-fitted to the 45° diagonal line which represented actual survival. Clinical decision curve analysis showed that the model had a significant positive net benefit in both the training and validation sets. Conclusion:The nomograph model for survival rate after radical resection of ICC was constructed based on four variables: ALBI, CA19-9, vascular tumor thrombus, and AJCC N staging (8th edition) in this study. This model provided a reference for more accurate prognosis evaluation and treatment selection plan for ICC patients.
Résumé
ObjectiveTo investigate the value of blood lipid indices and albumin-bilirubin index (ALBI) in evaluating the progression of chronic hepatitis B virus (HBV) infection. MethodsA total of 184 patients with chronic HBV infection who visited The Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divided into ASC group (74 HBV carriers), CHB group (70 patients with chronic hepatitis B), and LC group (40 patients with compensated cirrhosis). A total of 50 healthy individuals were enrolled as health control (HC) group. Blood lipid indices and liver function parameters were measured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was used to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indices of cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (APOA), and apolipoprotein B (F=12.075, 19.559, 6.554, 9.392, and 5.458, all P＜0.001), and the LC group had significantly greater reductions in the above indices compared with the other three groups (all P＜0.05). There was a significant difference in ALBI between the four groups (F=49.225, P＜0.001); the LC group had a significantly higher ALBI than the other three groups (all P＜005), and the ASC and CHB groups had a significantly higher ALBI than the HC group (both P＜0.05). CHO, HDL-C, LDL-C, and APOA were negatively correlated with ALBI (all P＜0.05), among which CHO and HDL-C had the strongest correlation with ALBI (r=-0.310 and -0.266, both P＜0.001). ConclusionIn patients with chronic HBV infection, blood lipid indices and ALBI can reflect the degree of liver function damage, especially in patients with liver cirrhosis.
Résumé
ObjectiveTo investigate the value of blood lipid indices and albumin-bilirubin index (ALBI) in evaluating the progression of chronic hepatitis B virus (HBV) infection. MethodsA total of 184 patients with chronic HBV infection who visited The Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divided into ASC group (74 HBV carriers), CHB group (70 patients with chronic hepatitis B), and LC group (40 patients with compensated cirrhosis). A total of 50 healthy individuals were enrolled as health control (HC) group. Blood lipid indices and liver function parameters were measured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis was used to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indices of cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (APOA), and apolipoprotein B (F=12.075, 19.559, 6.554, 9.392, and 5.458, all P＜0.001), and the LC group had significantly greater reductions in the above indices compared with the other three groups (all P＜0.05). There was a significant difference in ALBI between the four groups (F=49.225, P＜0.001); the LC group had a significantly higher ALBI than the other three groups (all P＜005), and the ASC and CHB groups had a significantly higher ALBI than the HC group (both P＜0.05). CHO, HDL-C, LDL-C, and APOA were negatively correlated with ALBI (all P＜0.05), among which CHO and HDL-C had the strongest correlation with ALBI (r=-0.310 and -0.266, both P＜0.001). ConclusionIn patients with chronic HBV infection, blood lipid indices and ALBI can reflect the degree of liver function damage, especially in patients with liver cirrhosis.