Aspartate aminotransferase-to-platelet ratio predicts response to transarterial chemoembolisation and prognosis in hepatocellular carcinoma patients.

Abstract

AIM:

To evaluate the value of the aspartate aminotransferase-to-platelet ratio index (APRI) for hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolisation (TACE).

MATERIALS AND METHODS:

A total of 315 patients were enrolled, who were randomly divided into the training cohort (n=158) and the validation cohort (n=157). The optimal cut-off value of the APRI was determined using the X-tile software in the training cohort, and was validated in the validation cohort. Several serum-based markers, neutrophil-to-lymphocyte (N/L) and aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratios were included to compare with the APRI. To predict individual survival rate, independent predictors were included to build a nomogram.

RESULTS:

Using the X-tile, a cut-off value of the APRI as 0.40 was yielded to distinguish patients with distinct outcomes in the training cohort, but failed for the N/L and ALT/AST ratios. In the training cohort, 66 patients with high APRI had poorer survival (p<0.001) than did 92 patients with low APRI. Using the same cut-off value of APRI, 61 patients with high APRI had poorer survival (p<0.001) than did 96 patients with low APRI in the validation cohort. Furthermore, a nomogram, including the APRI, TACE cycles, tumour size, and tumour number, was built based on the training cohort, and validated well in the validation cohort (concordance index [C-index] 0.713).

CONCLUSION:

The APRI is a promising marker to predict treatment response and outcome for HCC patients after TACE treatment.

• Authors: T Tang, J-L Qiu, G-W Li, M-P Huang, Y Li, Y-J Li, S-Z Gu
• Journal: Clinical radiology (Clin Radiol) Vol. 73 Issue 3 Pg. 259-265 (03 2018) ISSN: 1365-229X [Electronic] England
• PMID: 29032942 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Biomarkers, Tumor
• Ethiodized Oil
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Adult
• Aged
• Alanine Transaminase (blood)
• Antineoplastic Agents (administration & dosage)
• Aspartate Aminotransferases (blood)
• Biomarkers, Tumor (blood)
• Carcinoma, Hepatocellular (blood, diagnostic imaging, therapy)
• Chemoembolization, Therapeutic (methods)
• Ethiodized Oil (administration & dosage)
• Female
• Fluoroscopy
• Humans
• Liver Neoplasms (blood, diagnostic imaging, therapy)
• Male
• Middle Aged
• Platelet Count
• Predictive Value of Tests
• Prognosis
• Software
• Survival Analysis
• Treatment Outcome