【摘要】 目的 分析应用术前改良白蛋白-胆红素(mALBI)分级评估非乙肝相关性肝细胞癌(HCC)患者行根治性肝切除术后的生存预后。方法 收集2013年3月至2022年3月于广西壮族自治区人民医院接受根治性肝切除术的130例非乙肝相关性HCC患者的临床资料。根据mALBI评分结果分为mALBI 1级、mALBI 2a级、mALBI 2b级和mALBI 3级。比较不同级别患者的临床资料，采用Cox回归分析影响非乙肝相关性HCC患者生存预后的因素，应用Kaplan-Meier生存曲线分析不同mALBI分级患者的生存预后差异。结果 130例非乙肝相关性HCC患者中，mALBI 1级48例(36.92%),mALBI 2a级39例(30.00%),mALBI 2b级43例(33.08%),mALBI 3级0例(0.00%)。在随访期间，mALBI 1级患者死亡4例(8.33%),mALBI 2a级患者死亡5例(12.82%),mALBI 2b级患者死亡13例(30.23%)。mALBI 1级患者的生存预后显著优于mALBI 2a级和mALBI 2b级患者(log-rank检验：χ~2=13.560,P=0.005)。Cox回归分析结果显示，肿瘤直径≥5 cm(aHR=4.710)、微血管侵犯(MVI)(aHR=3.460),以及较高的mALBI评分(aHR=4.990)是影响非乙肝相关性HCC患者生存预后的独立危险因素(P<0.05)。结论 mALBI分级可用于预测非乙肝相关性HCC患者根治性肝切除后的生存预后，有助于临床及早干预，改善患者预后。更多还原

【Abstract】 Objective To analyse the survival prognosis after radical hepatectomy in non-hepatitis B associated with hepatocellular carcinoma(HCC) patients by using modified albumin-bilirubin(mALBI) grading.Methods The clinical data of 130 non-hepatitis B associated with HCC patients who received radical hepatectomy in the People′s Hospital of Guangxi Zhuang Autonomous Region from March 2013 to March 2022 were collected. According to the results of mALBI scores, they were divided into mALBI 1 grade, mALBI 2a grade, mALBI 2b grade and mALBI 3 grade. The clinical data were compared among the patients with different grades. Cox regression was used to analyze the factors affecting the survival prognosis of the non-hepatitis B associated with HCC patients, and Kaplan-Meier survival curve was used to analyze the difference in survival prognosis among the patients with different mALBI grades.Results Among the 130 non-hepatitis B associated with HCC patients in this study, 48 cases(36.92%) were mALBI 1 grade, and 39 cases(30.00%) were mALBI 2a grade, and 43 cases(33.08%) were mALBI 2b grade, and 0 cases(0.00%) were mALBI 3 grade. During the follow-up period, 4 cases(8.33%) of mALBI 1 grade died, and 5 cases(12.82%) of mALBI 2a grade died, and 13 cases(30.23%) of mALBI 2b grade died. The survival prognosis in the patients with mALBI 1 grade was significantly better than that in the patients with mALBI 2a grade and in the patients with mALBI 2b grade(log-rank test: χ~2=13.560, P=0.005). The results of Cox regression analysis showed that tumor diameter ≥5 cm(aHR=4.710), microvascular invasion(MVI)(aHR=3.460), and higher mALBI scores(aHR=4.990) were independent risk factors for the survival prognosis of the non-hepatitis B associated with HCC patients(P<0.05).ConclusionmALBI grading can be used to predict the survival prognosis of non-hepatitis B associated with HCC patients after radical hepatectomy, which is conducive to early clinical intervention and improvement of the patients′ prognosis.更多还原