Postoperative aspartate aminotransferase to platelet ratio index change predicts prognosis for hepatocellular carcinoma

Abstract

An elevated preoperative aspartate aminotransferase (AST) to platelet ratio index (APRI) is reported to be a prognostic factor for patients with hepatocellular carcinoma (HCC) after treatment. However, delta APRI (ΔAPRI), which represents the change from preoperative to postoperative APRI, has received little attention. The present study was designed to evaluate the prognostic value of ΔAPRI in patients with small HCC after liver resection.A retrospective cohort study analyzing 244 patients with small HCC who had undergone liver resection was conducted. Medical data were retrieved from our prospectively maintained database. Patients were divided into 2 groups according to ΔAPRI as follows: group A (ΔAPRI ≥0.02) and group B (ΔAPRI <0.02). The association of demographic and clinical data, overall survival (OS), and recurrence-free survival (RFS) were statistically compared in the 2 groups, and a multivariate analysis was used to identify prognostic factors.The 1, 3, and 5-year OS of patients in group A were 94.2%, 79.5%, and 62.3%, respectively, and 95.1%, 87.9%, and 84.6%, respectively, for patients in group B (P = 0.001). The corresponding 1, 3, and 5-year RFS was 69.0%, 44.7 %, and 28.1%, and 77.4%, 57.0%, and 54.2% for patients in the 2 groups, respectively (P = 0.009). The results of a multivariate analysis indicated that ΔAPRI was an independent prognostic factor for both OS (P = 0.001, hazard ratio 3.115, 95% confidence interval 1.642–5.912) and RFS (P = 0.006, hazard ratio 1.689, 95% confidence interval 1.163–2.452).A positive ΔAPRI after liver resection predicts decreased OS and RFS in patients with small HCC.

The Prognostic Value of aspartate aminotransferase to lymphocyte ratio and systemic immune-inflammation index for Overall Survival of Hepatocellular Carcinoma Patients Treated with palliative Treatments

“…Studies have suggested that APRI has a strong correlation with liver histopathological findings. As liver fibrosis and cirrhosis are crucial factors for development of HCC, APRI had also been reported to be as an independent prognostic factor in HCC patients with curative resection and radiofrequency ablation 29. Combining NLR and APRI may improve the prognostic accuracy in HCC patients after surgical resection.…”

Fibrosis-4 Model Influences Results of Patients with Hepatocellular Carcinoma Undergoing Hepatectomy

“…Thirdly, thrombocytopenia is common in HCC patients and may be explained by portal hypertension leading to pooling of platelets in an enlarged spleen, typically associated with cirrhosis [ 3 ]. Many studies [ 27 , 28 ] have identified platelet involvement in inflammatory responses, liver regeneration, and the regulation of angiogenesis, with additional studies demonstrating that platelet count and platelet-based models represent effective tools for the prediction of postoperative HCC recurrence, particularly late recurrence. Consequently, the fibrosis-4 model offers the potential ability to influence prognosis of HCC patients and represents a potential independent prognostic factor for both overall survival and disease-free survival.…”

Hematological and Biochemical Changes in Rats Induced With Diethyl Nitrosamine and the Hepatoprotective Role of Some Antioxidants

“…Recently, several serum markers that can be used as noninvasive tools have been identified in human cancers, including HCC (Lin et al, 2017) among them, there has been great interest in the aspartate aminotransferase-to-platelet ratio index (APRI) because it is an inexpensive and feasible test that can be used for daily oncologic practice. It has been reported that APRI might be a candidate as a prognostic biomarker in HCC and in cases of cirrhosis pre-HCC (Peng et al, 2016).…”