Clinical Significance Of Preoperative ALBI And PALBI In Predicting Prognosis After TACE In Patients With Primary Liver Cancer

Objective:To investigate the clinical value of preoperative albumin-bilirubin(ALBI)score and platelet-albumin-bilirubin(PALBI)score in predicting the prognosis of patients with primary liver cancer(PLC)after the first operation of transcatheter arterial chemoembolization(TACE),and to provide reference for the prognosis evaluation of PLC patients after TACE treatment.Methods: Retrospective analysis was conducted on the clinical data of 117 patients who were diagnosed as PLC and received TACE for the first time in the Affiliated Hospital of XX University from January 2010 to December 2015.The optimal thresholds of ALBI and PALBI were calculated by drawing receiver operating characteristic(ROC)curves,and the relationship between ALBI and PALBI and various clinicopathological parameters before TACE and overall survival(OS)was analyzed.Kaplan-Meier univariate analysis was used to obtain the parameters with statistical significance(P <0.05),and then they were included in the Cox multivariate analysis,from which the independent risk factors affecting the overall survival of patients after TACE were summarized,and the predictive value of these factors for patients with PLC after TACE was analyzed.Result:1.ROC curve analysis confirmed that the optimal critical values of ALBI and PALBI were-2.48 and-2.55,respectively,and the area under the ROC curve(AUC)was0.858 and 0.881,respectively.The optimal critical values were used as the cut-off points for grouping.The 1-year,3-year and 5-year survival rates in the low PALBI group and the high PALBI group were 95.74%,70.21%,61.70% and 71.42%,15.71%,1.42%,respectively.2.Univariate analysis showed that there was no statistical significance in gender,age,ethnicity,past history,Child-Pugh grade and AFP(P>0.05).Preoperative tumor size(P=0.003),tumor number(P =0.008),total bilirubin(P < 0.001),serum albumin(P =0.004),ALBI(P < 0.001)and PALBI(P < 0.001)were correlated with postoperative OS,with statistical significance.3.Multivariate Cox analysis showed that only ALBI and PALBI had statistical significance(P < 0.05),and the area under the ROC curve of PALBI(AUC> 0.881)was greater than that of ALBI(AUC>0.858).Conclusion:1.Preoperative ALBI>-2.48 predicted poor prognosis in PLC patients after TACE.2.Preoperative PALBI>-2.55 predicted poor prognosis in PLC patients after TACE.3.Preoperative PALBI was better than preoperative ALBI in predicting the prognosis of patients with primary liver cancer treated with TACE.