Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

Liver Cancer - Tập 6 Số 3 - Trang 204-215 - 2017
Atsushi Hiraoka1, Takashi Kumada2, Masatoshi Kudo3, Masashi Hirooka4, Kunihiko Tsuji5, Ei Itobayashi6, Kazuya Kariyama7, Toru Ishikawa8, Kazuto Tajiri9, Hironori Ochi10, Toshifumi Tada2, Hidenori Toyoda2, Kazuhiro Nouso7, Kouji Joko10, Hideki Kawasaki1, Yoichi Hiasa4, Kojiro Michitaka1
1Gastroenterology Center, Ehime Prefectural Central Hospital, Ehime,
2Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu,
3Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama,
4Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime,
5Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo,
6Department of Gastroenterology, Asahi General Hospital, Asahi,
7Department of Gastroenterology, Okayama City Hospital, Okayama,
8Department of Gastroenterology, Saiseikai Niigata Daini Hospital, Niigata,
9Department of Gastroenterology, Toyama University Hospital, Toyama, and
10Hepato-Biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan

Tóm tắt

Aim/Background: The purpose of this study was to evaluate the validity of 3 classifications for assessing liver function, the liver damage and Child-Pugh classifications and the newly proposed albumin-bilirubin (ALBI) grade, in order to examine the feasibility of evaluating hepatic function using ALBI grade with the hepatocellular carcinoma (HCC) treatment algorithm used in Japan. Methods: We analyzed the medical records of 3,495 Japanese HCC patients admitted from 2000 to 2015, which were comprised of 1,580 patients hospitalized in the Ehime Prefecture area and used as a training cohort (Ehime group), and 1,915 others who were used for validation (validation group). ALBI score used for grading (≤-2.60 = grade 1, greater than -2.60 to ≤-1.39 = grade 2, greater than -1.39 = grade 3) as well as clinical features and prognosis (Japan Integrated Staging [JIS], modified JIS, ALBI-TNM [ALBI-T] score) were retrospectively investigated. Results: For prediction of liver damage A, the values for sensitivity and specificity, positive predictive and negative predictive values, and positive and negative likelihood ratios of ALBI-1 and Child-Pugh A were similar among the 2 groups. Akaike information criterion results showed that prognosis based on ALBI grade/ALBI-T score was better than that based on liver damage/modified JIS score and Child-Pugh/JIS score (22,291.8/21,989.4, 22,379.6/22,076.0, 22,392.1/22,075.1, respectively). The cutoff values for ALBI score for indocyanine green retention rate at 15 min (ICG-R15) <10, <20, and <30% were -2.623 (area under the curve [AUC]: 0.798), -2.470 (AUC: 0.791), and -2.222 (AUC: 0.843), respectively. The distribution of ICG-R15 (<10%, 10 to <20%, 20 to <30%, and ≥30%) for ALBI grade 1 was similar to that for liver damage A. There were only small differences with regard to therapeutic selection with the Japanese HCC treatment algorithm between liver damage and ALBI grade. Conclusion: ALBI grade is a useful and easy classification system for assessment of hepatic function for therapeutic decision making.

Từ khóa


Tài liệu tham khảo

10.1111/hepr.12464

10.1111/j.1477-2574.2011.00329.x

10.1046/j.1365-2168.1997.02770.x

10.1002/ssu.2980090404

10.1002/bjs.1800600817

10.1016/j.hepres.2005.05.010

10.1200/JCO.2014.57.9151

10.1002/bjs.10095

10.1038/bjc.2016.33

10.1159/000447061

10.1111/jgh.13250

10.1111/liv.13170

10.1111/jgh.13291

10.1111/jgh.13457

10.1002/hep.20486

10.1007/s005350300038

10.1007/s00535-006-1878-y

10.1002/hep.20933

10.1111/j.1440-1746.2011.06678.x

10.1038/bmt.2012.244

10.1111/j.1440-1746.2009.06037.x

10.1016/S1053-0770(99)90267-7

10.1111/j.1478-3231.2004.0901.x

10.1056/NEJM199603143341104

10.1007/s00534-004-0950-3

10.1001/archsurg.138.11.1198

10.1001/archsurg.134.9.984

10.1159/000206151

10.1111/hepr.12697

10.1111/j.1872-034X.2007.00119.x

Thông tin
Thông tin xuất bản

Liver Cancer

Tập 6 Số 3

204-215

Thông tin tác giả