Value of albumin-bilirubin score combined with aspartate aminotransferase-to-platelet ratio index in predicting the development of posthepatectomy liver failure in patients with HBV-related hepatocellular carcinoma

Objective To investigate the value of albumin-bilirubin (ALBI) score combined with aspartate aminotransferase-to-platelet ratio index (APRI) in predicting the development of posthepatectomy liver failure (PHLF) in patients with HBV-related hepatocellular carcinoma (HCC) .Methods A retrospective analysis was performed for the patients with HBV-related HCC who underwent hepatectomy in The Affiliated Tumor Hospital of Guangxi Medical University from January 2006 to October 2013.With Child-Pugh score as control, the values of ALBI, APRI, and ALBI combined with APRI in predicting PHLF were analyzed.The chi-square test or the Fisher exact test was used for comparison of categorical data between groups, and the logistic regression model was used to identify independent predictive indices for PHLF.Results A total of 1055 patients were enrolled in this study, among whom 151 (14.3%) experienced PHLF.The univariate and multivariate analyses showed that ALBI and APRI were significantly associated with the prognosis of PHLF patients (P < 0.001) .ALBI and APRI had a significantly higher area under the receiver operating characteristic curve (AUC) than Child-Pugh score (both P<0.001) .albi="" had="" a="" sensitivity="" of="" and="" specificity="" in="" predicting="" phlf="" at="" the="" optimal="" cut-off="" value="" patients="" with="" albi="">-2.77 had a significantly higher incidence rate of PHLF A/B/C than those with ALBI ≤-2.77 (P < 0.001) .APRI had a sensitivity of 61.6% and a specificity of 71.0% in predicting PHLF at the optimal cut-off value of 0.85, and the patients with APRI >0.85 had a significantly higher incidence rate of PHLF A/B/C than those with APRI ≤0.85 (P < 0.001) .The combination of ALBI and APRI had a significantly higher AUC than ALBI or APRI (P < 0.001 and P = 0.047) .The combination of ALBI and APRI had a sensitivity of 78.1% and a specificity of 62.2% in predicting PHLF at the optimal cut-off value of-13.10, and the patients with the combination of ALBI and APRI >-13.10 had a significantly higher incidence rate of PHLF A/B/C than those with the combination of ALBI and APRI ≤-13.10 (P < 0.001) .Conclusion ALBI combined with APRI can be used as a new, convenient, and reliable index for predicting PHLF.