[Prognostic significance of albumin/globulin ratio on postoperative survival of patients with hepatocellular carcinoma].

Objective: To investigate the prognostic value of albumin/globulin ratio on postoperative survival outcomes in patients with hepatocellular carcinoma. Methods: Data of 630 patients with HCC, who underwent surgical resection from February 2009 to July 2013, were retrospectively analyzed. Patients were divided into low-value group (A/G < 1.5, defined as L group) and high-value group (A/G≥1.5, defined as H group), and their distribution characteristics were observed with the normal A/G threshold value. Independent risk factors' affecting survival and prognosis was analyzed with univariate and multivariate Cox's regression model. Survival trend of all patients with low-value and high-value groups in A, B and C of Barcelona stage (BCLC stage) were analyzed using the Kaplan-Meier method. Results: Multivariate analysis showed that preoperative A/G ratio (P = 0.007), alpha-fetoprotein (P < 0.001), gamma-glutamyltransferase (P = 0.006), RBC (P = 0.014), international normalized ratio (P = 0.009), preoperative BCLC staging (P < 0.001) and number of tumors (P = 0.003), and intraoperative blood transfusion (P < 0.001) were independent prognostic factors affecting long-term survival in HCC patients. The median overall survival time in-group L was 15 months, significantly lower than that in group H of 42 months (P < 0.001). Stratified analysis showed that the short-term survival advantage of patients with high A / G value was limited to those with Barcelona stage A (P < 0.001), and disappeared in patients with Barcelona stage B and C (P > 0.05). The long-term survival advantage existed in patients with Barcelona stage A (P < 0.001), B (P < 0.05), and disappeared in C (P > 0.05). Conclusion: Preoperative albumin/globulin ratio can predict postoperative prognosis and survival, and direct towards the treatment for early stage of HCC and thus representing as an indicator of high clinical value.目的： 探究白蛋白与球蛋白比值（A/G）对肝癌（HCC）患者术后生存预后的影响及其临床价值。 方法： 回顾性分析2009年2月至2013年7月收治的行手术切除的630例HCC患者资料。根据A/G的正常下限值将患者分为低值组（A/G < 1.5，简称L组）和高值组（A/G≥1.5，简称H组），并观察其分布特征。应用Cox单因素和多因素回归分析影响患者生存预后的独立危险因素；Kaplan-Meier法分析所有患者和巴塞罗那分期（BCLC分期）A、B、C各期低值组和高值组的生存趋势。 结果： 多因素分析显示：术前A/G（P = 0.007）、甲胎蛋白水平（P < 0.001）、γ-谷氨酰转移酶水平（P = 0.006）、红细胞计数（P = 0.014）、国际标准化比值（P = 0.009）、术前BCLC分期（P < 0.001）及肿瘤数目（P = 0.003）、术中输血（P < 0.001）状态是HCC患者术后长期生存的独立影响因素。在630例患者中，L组总生存（OS）的中位生存时间仅为15个月，显著低于H组的42个月（P < 0.001）。分层分析显示：A/G高值组患者的近期生存优势仅限于BCLC A期患者（P < 0.001），在B期和C期患者中消失（P > 0.05）；而远期生存优势则存在于BCLC A（P < 0.001）和B期中（P < 0.05），在C期患者中消失（P > 0.05）。 结论： 术前A/G能够预测HCC患者预后，指导早期HCC患者的治疗，是一个具有较高临床应用价值的指标。.