PDF(Pubmed)
Abstract：
Tumour morphology (tumour burden score (TBS)) and liver function (albumin-to-alkaline phosphatase ratio (AAPR)) have been shown to correlate with outcomes in intrahepatic cholangiocarcinoma (ICC). This study aimed to evaluate the combined predictive effect of TBS and AAPR on survival outcomes in ICC patients. We conducted a retrospective analysis using a multicentre database of ICC patients who underwent curative surgery from 2011 to 2018. The Kaplan-Meier method was employed to examine the relationship between a new index (combining TBS and AAPR) and long-term outcomes. The predictive efficacy of this index was compared to other conventional indicators. A total of 560 patients were included in the study. Based on TBS and AAPR stratification, patients were classified into three groups. Kaplan-Meier curves demonstrated that 124 patients with low TBS and high AAPR had the best overall survival (OS) and recurrence-free survival (RFS), while 170 patients with high TBS and low AAPR had the worst outcomes (log-rank p < 0.001). Multivariate analyses identified the combined index as an independent predictor of OS and RFS. Furthermore, the index showed superior accuracy in predicting OS and RFS compared to other conventional indicators. Collectively, this study demonstrated that the combination of liver function and tumour morphology provides a synergistic effect in evaluating the prognosis of ICC patients. The novel index combining TBS and AAPR effectively stratified postoperative survival outcomes in ICC patients undergoing curative resection.
摘要：
已显示肿瘤形态（肿瘤负荷评分（TBS））和肝功能（白蛋白与碱性磷酸酶比率（AAPR））与肝内胆管癌（ICC）的预后相关。本研究旨在评估TBS和AAPR对ICC患者生存结局的联合预测作用。我们使用2011年至2018年接受治愈性手术的ICC患者的多中心数据库进行了回顾性分析。采用Kaplan-Meier方法检查新指标（结合TBS和AAPR）与长期结果之间的关系。将该指标的预测效果与其他常规指标进行比较。共有560名患者被纳入研究。基于TBS和AAPR分层，患者分为三组.Kaplan-Meier曲线显示124例TBS低、AAPR高的患者总生存期（OS）和无复发生存期（RFS）最好。而170例高TBS和低AAPR患者的结局最差（log-rankp<0.001）。多变量分析确定组合指数是OS和RFS的独立预测因子。此外，与其他常规指标相比，该指数在预测OS和RFS方面显示出较高的准确性。总的来说，这项研究表明，肝功能和肿瘤形态学的组合在评估ICC患者的预后方面具有协同作用。结合TBS和AAPR的新指标可有效地对接受根治性切除术的ICC患者的术后生存结果进行分层。
