2022 年第 5 期 第 17 卷

白蛋白-胆红素评分和糖类抗原19-9/胆红素比值对胰头导管腺癌患者术后复发的预测价值

Value of albumin bilirubin score and carbohydrate antigen 19-9/bilirubin ratio in predicting postoperative recurrence of pancreatic ductal adenocarcinoma

作者：易静静夏杏芳闵琴

英文作者：Yi Jingjing Xia Xingfang Min Qin

单位：华中科技大学同济医学院附属梨园医院普通外科，武汉430077

英文单位：Department of General Surgery Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology Wuhan 430077 China

关键词：胰头导管腺癌；白蛋白；胆红素；糖类抗原19-9

英文关键词：Pancreaticductaladenocarcinoma;Albumin;Bilirubin;Carbohydrateantigen19-9

• 摘要：

• 目的 探讨白蛋白-胆红素（ALBI）评分和糖类抗原19-9（CA19-9）/胆红素比值对胰头导管腺癌患者术后复发的预测价值。方法 回顾性分析2016年1月至2020年1月于华中科技大学同济医学院附属梨园医院行根治性胰十二指肠切除的85例胰头导管腺癌患者的临床资料。根据随访预后情况将患者分为复发组（34例）和无复发组（51例）。比较2组患者的临床资料，分析术后复发的影响因素，以及ALBI评分和CA19-9/胆红素比值对胰头导管腺癌患者行根治性胰十二指肠切除术后复发的预测价值。结果 复发组淋巴结转移比例、淋巴结转移数≥4枚比例、ALBI评分和CA19-9/胆红素比值均高于无复发组［52.9%(18/34)比29.4%（15/51）、35.3%(12/34)比5.9%（3/51）、（-1.79±0.25）分比（-2.53±0.36）分、（4.9±1.0）比（3.5±0.6）］（均P＜0.05）。Logistic回归分析结果显示，淋巴结转移数≥4枚、ALBI评分≥-2.22分、CA19-9/胆红素比值≥4.9均为胰头导管腺癌患者行根治性胰十二指肠切除术后复发的影响因素（比值比=2.872、1.408、1.640，均P＜0.05）。ALBI评分和CA19-9/胆红素比值联合预测胰头导管腺癌患者行根治性胰十二指肠切除术后复发的曲线下面积高于其中任一项单独检测（0.950比0.723、0.773）（Z=4.312、3.450，均P＜0.001）。结论  ALBI评分≥-2.22分和CA19-9/胆红素比值≥4.9均为胰头导管腺癌患者行根治性胰十二指肠切除术后复发的影响因素，二者联合预测胰头导管腺癌患者行根治性胰十二指肠切除术后复发的价值高于其中任一项单独检测。

• Objective  To investigate the value of albumin bilirubin (ALBI) score and carbohydrate antigen19-9(CA19-9)/bilirubin ratio in predicting postoperative recurrence of pancreatic ductal adenocarcinoma. Methods The clinical data of 85 patients with pancreatic ductal adenocarcinoma admitted to Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2016 to January 2020 were analyzed retrospectively. According to the follow-up prognosis, patients were divided into recurrence group (34 cases) and non recurrence group (51 cases). The clinical data of the two groups were compared to analyze the risk factors of recurrence after radical pancreaticoduodenectomy in patients with pancreatic ductal adenocarcinoma. The predictive value of ALBI score and CA19-9/bilirubin ratio in predicting postoperative recurrence of pancreatic ductal adenocarcinoma was analyzed. Results  The proportion of lymph node metastasis, the proportion of lymph node metastasis number ≥4, ALBI score and CA19-9/bilirubin ratio in the recurrence group were higher than those in the non recurrence group ［52.9%(18/34) vs 29.4%(15/51), 35.3%(12/34) vs 5.9%(3/51), (-1.79±0.25) vs (-2.53±0.36), (4.9±1.0) vs (3.5±0.6)］ (all P<0.05). Logistic regression analysis showed that lymph node metastases number ≥4, ALBI score ≥-2.22 and CA19-9/bilirubin ratio≥4.9 were the risk factors of recurrence after radical pancreaticoduodenectomy (odds ratio=2.872, 1.408, 1.640, all P<0.05). The area under the curve of combined prediction of ALBI score and CA19-9/bilirubin ratio in predicting recurrence after radical pancreaticoduodenectomy in patients with pancreatic ductal adenocarcinoma was higher than that of ALBI score and CA19-9/bilirubin ratio alone (0.950 vs 0.723, 0.773)(Z=4.312, 3.450, both P<0.001). Conclusions The ALBI score ≥-2.22 and CA19-9/bilirubin ratio ≥4.9 are risk factors in recurrence of pancreatic ductal adenocarcinoma after radical pancreaticoduodenectomy, and the both combination has high value in predicting the recurrence.