Comparison Of MELD,ALBI And APRI Scores In Predicting Post-hepatectomy Liver Failure In Patients With Liver Cancer

Objectives Post-hepatectomy Liver Failure(PHLF)for liver tumors is a common problem in liver surgery.Therefore,the assessment of liver reserve function is an important task before liver surgical resection.At present,there are many methods to predict liver reserve function,which are of great significance in the prediction of Post-hepatectomy Liver Failure in patients with primary liver cancer.among which the albumin-bilirubin scoring model,model for end-stage liver disease and aspartate aminotransferase platelet ratio index are the commonly used scoring models to assess liver function reserve.In this study,by comparing the predictive value of MELD score,ALBI score and APRI score for after hepatectomy in hepatocellular carcinoma patients of grade Child A,explored and summarized the evaluation method of liver reserve function before liver cancer operation to guide clinical work.Methods Through collecting 67 cases of liver resection for primary liver cancer of grade Child A from January 2014 to September 2018,Retrospective analysis of clinical data,According to the standard of liver dysfunction after liver cancer surgery proposed by International Study Group of Liver Surgery in 2011,21 of the 67 patients were diagnosed with PHLF,analysis to predict PHLF independent predictor.The ability of MELD score,ALBI score and APRI score to predict PHLF was analyzed.According to the range of liver resection,the enrolled patients were divided into two subgroups: the small-range resection group and the large-range resection group,and the ability of MELD score,ALBI score and APRI score to predict PHLF in the two subgroups was further compared.Results The MELD score,ALBI score and APRI score of PHLF patients were significantly higher than that of non-phlf patients,with statistically significant differences(P<0.05).The area under the ROC curve of MELD score,ALBI score and APRI score prediction were 0.726,0.715 and 0.847,indicating that the value of PHLF predicted by each score was statistically significant(P<0.05).According to the liver resection range,the patients were divided into small-range resection patients and large-range resection patients.The areas under the curve of PHLF predicted by MELD score,ALBI score and APRI score of small-range resection patients were 0.848,0.875 and 0.879,which indicated that the value of PHLF predicted by each score was statistically significant(P<0.05).The area under the ROC curve predicted by MELD score,ALBI score and APRI score of patients with large range resection was 0.664,0.559 and 0.769,respectively.The P value corresponding to APRI score was less than 0.05,indicating that the value of APRI score in predicting PHLF was statistically significant.Conclusions 1 The range of liver resection,tumor diameter,cirrhosis and AST are independent risk factors for PHLF.2 Among the three scoring systems,APRI score is better than MELD score and ALBI score in predicting PHLF after R0 resection.APRI score can be used as a supplement to Child-Pugh grading and ICG test to predict PHLF in HCC patients undergoing surgical treatment.3 APRI score is better than MELD score and ALBI score in predicting PHLF in both patients with large-scale hepatectomy and patients with small-scale hepatectomy.Figure[3];Table[9];Reference[134]...