背景:一些研究表明,BALAD评分包括HCC肿瘤标志物,法新社,AFP-L3%,DCP,血清白蛋白和胆红素值是所有治疗方式的HCC患者的良好预测因子。在这项研究中,我们的目的是阐明BALAD评分作为HCC患者根治性手术后预后因素的影响.
方法:本研究调查了2003年1月至2013年5月期间578例接受肝癌肝切除术的患者。累积复发率,总生存期(OS),根据BALAD评分水平分析临床病理参数。
结果:在BALAD评分较高的患者中,复发率和OS较差(分别为p=0.0015和p<0.0001).多因素分析显示复发的独立危险因素为男性(风险比[HR]1.52,P=0.011),HCV抗体阳性(HR1.33,P=0.019),多发性肿瘤(HR2.16,P<0.0001),微血管侵犯(HR1.45,P=0.0035)和较高的BALAD评分(RR1.70,P=0.015)。OS的独立危险因素为多发肿瘤(HR1.52,P=0.014),微血管侵犯(HR1.53,P=0.012),和更高的BALAD评分(RR2.51,P=0.0012)。
结论:BALAD评分与肝癌根治性肝切除术患者的高复发率和低总生存率相关。
BACKGROUND: Several studies have indicated that BALAD score which includes the HCC tumor markers of HCC, AFP, AFP-L3%, DCP, and serum albumin and bilirubin value were good predictors of HCC patients for all treatment modalities. In this study, we aim to clarify the impact of BALAD score as the prognostic factor for HCC patients after curative surgery.
METHODS: This study investigated 578 patients who underwent hepatectomy for HCC between January 2003 and May 2013. Cumulative recurrence rate, overall survival (OS), and clinicopathological parameters were analyzed according to the level of BALAD score.
RESULTS: In patients with higher BALAD score, recurrence rate and OS was poor (p = 0.0015 and p < 0.0001, respectively). Multivariate analyses revealed independent risk factors for recurrence to be male (hazard ratio [HR] 1.52, P = 0.011), HCV-antibody positive (HR 1.33, P = 0.019), multiple tumors (HR 2.16, P < 0.0001), microvascular invasion (HR 1.45, P = 0.0035) and higher BALAD score (RR 1.70, P = 0.015). The independent risk factors for OS were multiple tumors (HR 1.52, P = 0.014), microvascular invasion (HR 1.53, P = 0.012), and higher BALAD score (RR 2.51, P = 0.0012).
CONCLUSIONS: BALAD score is associated with high recurrence rate and poor overall survival of the patients who underwent curative liver resection for HCC.