Turn off MathJax
Article Contents
FAN Wanli, HE Dong, ZHANG Shuze, CHEN Gang, ZHAO Bin, CHENG Zhibin. The Predictive Value of Albumin-bilirubin Score Combined with Liver Function Index and CEA for Liver Metastasis of Colorectal Cancer[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0261
Citation: FAN Wanli, HE Dong, ZHANG Shuze, CHEN Gang, ZHAO Bin, CHENG Zhibin. The Predictive Value of Albumin-bilirubin Score Combined with Liver Function Index and CEA for Liver Metastasis of Colorectal Cancer[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0261

The Predictive Value of Albumin-bilirubin Score Combined with Liver Function Index and CEA for Liver Metastasis of Colorectal Cancer

doi: 10.12290/xhyxzz.2023-0261
Funds:

National Natural Science Foundation(82060508)

  • Received Date: 2023-05-31
  • Accepted Date: 2023-08-01
  • Available Online: 2023-08-21
  • Objective To investigate the predictive value of albumin-bilirubin (ALBI) score combined with liver function index and carcinoembryonic antigen (CEA) for liver metastasis of colorectal cancer. Methods The clinical data of patients with colorectal cancer who underwent surgical treatment in the Second Hospital of Lanzhou University from January 2016 to July 2021 and were followed up for 24 months were retrospectively analyzed. According to the follow-up results, the enrolled patients were divided into liver metastasis group and non-liver metastasis group, and were randomly divided into modeling group and validation group according to the ratio of 2:1. The risk factors of liver metastasis in patients with colorectal cancer were analyzed. Lasso-Logistic regression was used to construct the prediction model. Bootstrap method was used for internal verification. Receiver operating characteristic curve, calibration curve and clinical decision curve were used to evaluate the reliability of the prediction model. Finally, a nomogram was drawn to show the prediction results. Results A total of 195 patients who met the inclusion and exclusion criteria were enrolled, including 130 in the modeling group and 65 in the validation group. Through Lasso regression variable screening and Logistic regression analysis, the results showed that ALBI (OR=8.062,95% CI:2.545~25.540), alanine transaminase (ALT) (OR=1.037,95% CI:1.004~1.071) and CEA (OR=1.025,95% CI:1.008~1.043) were independent predictors of liver metastasis in colorectal cancer. The area under curve (AUC) of the combined prediction of liver metastasis of colorectal cancer in the modeling group was 0.921, the sensitivity was 78%, the specificity was 95%, the C-index was 0.921, the H-L fitting curve X2=0.851, P=0.654, and the slope of the calibration curve was close to 1, suggesting that the accuracy of the model was high, and the DCA curve showed that the model had good clinical application value. For the data of the modeling group, the Bootstrap method was used for internal verification of 1000 resamplings. The accuracy was 0.869, the kappa consistency was 0.709, and the AUC was 0.913. When ALBI, ALT and CEA were used to diagnose liver metastasis of colorectal cancer alone, the AUC of CEA was the largest (0.897), and the combination of the three had the highest efficacy in the diagnosis of liver metastasis of colorectal cancer. In the validation group, the AUC, sensitivity, specificity, Cindex and H-L curve of the combined prediction of liver metastasis of colorectal cancer were 0.918, 85%, 95.6%, 0.918, X2=0.586, P=0.746, respectively. Conclusion ALBI, ALT and CEA have certain predictive value for liver metastasis of colorectal cancer. The combined diagnosis of liver metastasis of colorectal cancer has high efficacy, and the risk prediction model constructed by them has a good predictive effect.
  • loading
  • [1] Xu J,Fan J,Qin X,et al.Chinese guidelines for the diagnosis and comprehensive treatment of colorectal liver metastases (version 2018)[J].J Cancer Res Clin Oncol,2019,145:725-736.
    [2] Zheng RS,Zhang SW,Zeng HM,et al.Cancer incidence and mortality in China,2016[J].Journal of the National Cancer Center,2022,2:1-9.
    [3] Giannis D,Sideris G,Kakos CD,et al.The role of liver transplantation for colorectal liver metastases:A systematic review and pooled analysis[J].Transplant Rev(Orlando),2020,34:100570- 100570.
    [4] Norén A,Sandström P,Gunnarsdottir K,et al.Identification of inequalities in the selection of liver surgery for colorectal liver metastases in Sweden[J].Scand J Surg,2018,107:294-301.
    [5] Siegel RL,Miller KD,Goding Sauer A,et al.Colorectal cancer statistics,2020[J].CA Cancer J Clin,2020,70:145-164.
    [6] WolfAMD,FonthamETH,ChurchTR,et al.Colorectal cancer screening for average-risk adults:2018 guideline update from the American Cancer Society[J].CA Cancer J Clin,2018,68:250-281.
    [7] Van CutsemE,CervantesA,AdamR.et al.ESMO consensus guidelines for the management of patients with metastatic colorectal cancer[J].Ann Oncol,2016,27:1386-1422.
    [8] 陈小玲,焦晓多,伍勇,等.肝癌患者血清中透明质酸、层粘蛋白、Ⅵ型胶原的测定及临床意义[J].临床和实验医学杂志,2010,9:1041-1043.
    [9] Johnson PJ, Berhane S, Kagebayashi C,et al.Assessment of liver function in patients with hepatocellular carcinoma:A new evidence-based approach-the ALBI grade[J].J Clin Oncol,2015,33:550-558.
    [10] Yagyu T,Saito H,Sakamoto T,et al.Preoperative Albumin-Bilirubin Grade as a Useful Prognostic Indicator in Patients With Pancreatic Cancer[J].Anticancer research, 2019,39:1441- 1446.
    [11] 段丽宁,常宁,赵亚静,等.血清肿瘤标志物联合肝功能指标检测对结肠癌肝转移的诊断价值[J].中华肿瘤防治杂志,2022,29:1206-1210.
    [12] 马运宾,刘骞.术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用[J].中华结直肠疾病电子杂志,2018,7:453-457.
    [13] Xue J,Li J,Liang J,et al.The prevalence of mild cognitive impairment in China:a systematic review[J].Aging and disease,2018,9:706-715.
    [14] 惠鹏, 刘连 新, 梁英 健. 结直 肠癌 肝转 移的 分子 机制 研究 进展[J]. 中国 普外 基础 与临 床杂 志,2019,26:758-763.
    [15] Cong ZJ, Hu LH, Ji JT, et al.A long-term follow-up study on the prognosis of endoscopic submucosal dissection for colorectal laterally spreading tumors[J].Gastrointest Endosc,2016, 83:800-807.
    [16] 王娜.术前血清CEA、CA19-9、CA50、AFP和TPS检测对结直肠癌肝转移的预测价值[J].中国肛肠病杂志,2021,41:1-3.
    [17] Lee JH,Lee SW.The roles of carcinoembryonic antigen in liver metastasis and therapeutic approaches[J]. Gastroenterol Res Pract,2017,2017:7521987.
    [18] Duffy MJ,van Dalen A,Haglund C,et al.Tumor markers in colorectal cancer:European Group on Tumor Markers (EGTM) guidelines for clinical use[J].Eur J Cancer,2007,43:1348-1360.
    [19] Misiakos EP,Karidis NP,Kouraklis G.Current treatmentfor colorectal liver metastases[J].World J Gastroenterol,2011,17:4067-4075.
    [20] 邓玉雪, 官玲玲.比较几种血清肿瘤标志物在结直肠癌及其肝转移的诊断价值[J].中国实用医药, 2017,12:79-80.
    [21] 苏阜力,张补文.血清酶活性联检在肝病中的应用[J].实用医技杂志,2006,14:2435-2436.
    [22] 赵杰,余海波,朱运海,等.肝癌根治术前GGT, ALT/AST和术后临床病理特征与预后的关系[J].中华普通外科杂志,2019,34:328-331.
    [23] 鲁立峰,盛勤松,邹德胜,等.结直肠癌切除联合射频消融对同时性结直肠癌肝转移临床指标、安全性及预后的影响[J].中华全科医学,2018,16:736-739.
    [24] 白傲雪,张宁苏,董野等.结直肠癌肝转移的相关因素[J].实用中医内科杂志,2020,34:120-123.
    [25] Wu XZ,Ma F,Wang XL.Serological diagnostic factors for liver metastasis in patients with colorectal cancer[J].World J Gastroenterol,2010,16:4084-4088.
    [26] 敬蕾,常玉霞,党元娜.胰腺癌术后发生肝转移的影响因素分析[J].实用癌症杂志,2022,37:108-110.
    [27] Thibaut MM,Sboarina M,Roumain M,et al.Inflammation-induced cholestasis in cancer cachexia[J].J Cachexia Sarcopenia Muscle,2021,12:70-90.
    [28] Baracos VE,Martin L,Korc M,et al.Cancer-associated cachexia[J].Nat Rev Dis Prim, 2018,4:17105.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (36) PDF downloads(9) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return