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Albumin-to-Alkaline Phosphatase Ratio Associates with Good Prognosis of Hepatitis B Virus-Positive HCC Patients

Authors Li Q, Lyu Z, Wang L, Li F, Yang Z, Ren W

Received 12 December 2019

Accepted for publication 26 February 2020

Published 20 March 2020 Volume 2020:13 Pages 2377—2384

DOI https://doi.org/10.2147/OTT.S242034

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Takuya Aoki


Qun Li,1,* Zhuozhen Lyu,1,* Liguang Wang,2,* Feifei Li,1 Zhen Yang,1 Wanhua Ren1

1Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People’s Republic of China; 2Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wanhua Ren
Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People’s Republic of China
Email renwanhua001@163.com

Purpose: The aim of this study was to investigate the prognostic significance of preoperative AAPR in hepatitis B virus-related hepatocellular carcinoma patients after curative hepatectomy.
Patients and Methods: A total of 221 patients with hepatitis B virus-related HCC patients who received curative liver resection were included. After propensity matching analysis, 188 patients were enrolled in the final analysis. COX regression analyses were used to analyze the prognosis value of AAPR and other prognostic factors. The overall survival (OS) and recurrence-free survival (RFS) curves were constructed and compared between different groups.
Results: The optimal cutoff of AAPR was defined as 0.40 with X-tile software. According to cutoff value, patients were divided into low-AAPR group (≤ 0.40) and high-AAPR group (> 0.40). The cumulative 1-, 3-, and 5-year OS rates were 97.1%, 78.2%, and 67.3% in patients with AAPR> 0.40 group, respectively, which were significantly higher than those in the AAPR≤ 0.40 group (80.2%, 54.4%, and 40.1%, respectively) (P < 0.001). In the multivariate COX regression analysis, AAPR, tumor number, ascites, and portal vein tumor thrombus (PVTT) were independent risk factors for OS and RFS.
Conclusion: AAPR shows promise as a reliable prognostic factor in patients with hepatitis B virus-related HCC after curative hepatectomy, which could be used as a routine inspection of HCC patients before surgery.

Keywords: albumin-to-alkaline phosphatase ratio, prognosis, hepatitis B virus, hepatocellular carcinoma

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