Abstract：
OBJECTIVE: This study aimed to evaluate the clinical significance of the preoperative aminotransferase to albumin ratio (AAR) in patients with hepatocellular carcinoma (HCC) after hepatectomy.
METHODS: From five hospitals, a total of 991 patients with HCC admitted between December 2014 and December 2019 were included as the primary cohort and 883 patients with HCC admitted between December 2010 and December 2014 were included as the validation cohort. The X-tile software was conducted to identify the optimal cut-off value of AAR.
RESULTS: In the primary cohort, the optimal cut-off value of the AAR was defined as 0.7 and 1.6, respectively. Compared to patients with AAR 0.7-1.6, those with AAR > 1.6 showed significantly worse overall survival (OS) and RFS, whereas those with AAR < 0.7 showed significantly better OS and RFS (all p < 0.001). Pathologically, patients with AAR > 1.6 had more aggressive tumour characteristics, such as larger tumour size, higher incidence of microvascular invasion, and severe histologic activity, and higher AFP level than patients with AAR < 0.7. Consistently, the abovementioned clinical significance of AAR was confirmed in the validation cohort.
CONCLUSIONS: A high AAR was significantly correlated with advanced tumours and severe hepatic inflammation, and a worse prognosis of HCC.
METHODS: From five hospitals, a total of 991 patients with HCC admitted between December 2014 and December 2019 were included as the primary cohort and 883 patients with HCC admitted between December 2010 and December 2014 were included as the validation cohort. The X-tile software was conducted to identify the optimal cut-off value of AAR.
RESULTS: In the primary cohort, the optimal cut-off value of the AAR was defined as 0.7 and 1.6, respectively. Compared to patients with AAR 0.7-1.6, those with AAR > 1.6 showed significantly worse overall survival (OS) and RFS, whereas those with AAR < 0.7 showed significantly better OS and RFS (all p < 0.001). Pathologically, patients with AAR > 1.6 had more aggressive tumour characteristics, such as larger tumour size, higher incidence of microvascular invasion, and severe histologic activity, and higher AFP level than patients with AAR < 0.7. Consistently, the abovementioned clinical significance of AAR was confirmed in the validation cohort.
CONCLUSIONS: A high AAR was significantly correlated with advanced tumours and severe hepatic inflammation, and a worse prognosis of HCC.
摘要：
目的：本研究旨在评估术前转氨酶与白蛋白比值（AAR）在肝细胞癌（HCC）肝切除术后的临床意义。
方法：来自五家医院，纳入2014年12月至2019年12月期间收治的991例HCC患者作为主要队列,纳入2010年12月至2014年12月期间收治的883例HCC患者作为验证队列.进行X-tile软件以确定AAR的最佳截止值。
结果：在主要队列中，AAR的最佳临界值分别定义为0.7和1.6。与AAR0.7-1.6的患者相比，AAR>1.6的患者显示出明显更差的总生存期（OS）和RFS，而AAR<0.7的患者表现出明显更好的OS和RFS（均p<0.001）。病理上,AAR>1.6的患者具有更具侵袭性的肿瘤特征，比如更大的肿瘤，微血管侵犯的发生率较高，和严重的组织学活动，AFP水平高于AAR<0.7的患者。始终如一，上述AAR的临床意义在验证队列中得到证实.
结论：高AAR与晚期肿瘤和严重肝脏炎症显著相关，肝癌的预后较差。
方法：来自五家医院，纳入2014年12月至2019年12月期间收治的991例HCC患者作为主要队列,纳入2010年12月至2014年12月期间收治的883例HCC患者作为验证队列.进行X-tile软件以确定AAR的最佳截止值。
结果：在主要队列中，AAR的最佳临界值分别定义为0.7和1.6。与AAR0.7-1.6的患者相比，AAR>1.6的患者显示出明显更差的总生存期（OS）和RFS，而AAR<0.7的患者表现出明显更好的OS和RFS（均p<0.001）。病理上,AAR>1.6的患者具有更具侵袭性的肿瘤特征，比如更大的肿瘤，微血管侵犯的发生率较高，和严重的组织学活动，AFP水平高于AAR<0.7的患者。始终如一，上述AAR的临床意义在验证队列中得到证实.
结论：高AAR与晚期肿瘤和严重肝脏炎症显著相关，肝癌的预后较差。
