- 期刊
- Ahead-of-Print
運用白蛋白膽紅素評分系統（ALBI）預測術後肝衰竭發生之回顧
Review: Prediction of Post Hepatectomy Liver Failure in Patients with Liver Cancer by Albumin-Bilirubin Grade (ALBI)
摘要
肝臟術後衰竭（Post-hepatectomy liver failure, PHLF）為肝腫瘤術後嚴重合併症之一，PHLF具統計致死率高達9.3％的比率。故本文旨在探討PHLF定義、相關因素，以及比較目前臨床常見之肝腫瘤切除術前預測工具Child-Pugh分級、末期肝病模型（The model of end-stage liver disease, MELD）、靛氰綠測試15分鐘滯留率（Indocyanine green retention test, ICG-R15）和白蛋白膽紅素（Albumin-Bilirubin, ALBI）評分之準確性。藉由文獻回顧和資料整合分析發現，ALBI之曲線下面積（Area under receiver operating characteristic curves, AUROC）顯著高於Child-Pugh、MELD、ICG-R15，為目前臨床預測PHLF最準確計算工具之一，並具備預估PHLF嚴重度和肝腫瘤切除術後膽漏的發生率。然而，因ALBI初始發展目的僅做為估計肝癌病患存活率預估，未來應對ALBI等級與數據分界點做進一步分析，並結合影像醫學技術以提升準確度，以期裨益於共享醫療決策（Shared decision making, SDM）。
並列摘要
Post-hepatectomy liver failure (PHLF) is a severe complication after hepatectomy with a high mortality rate of 9.3%. This article explores the definition of PHLF and the related risk factors, and compares the accuracy of the Child-Pugh score, end-stage liver disease (MELD) model, Indocyanine green retention test (ICG-R15), and albumin-bilirubin (ALBI) in predicting the development of PHLF in liver cancer patients. According to the literature review and data analysis, ALBI had more area covered under the receiver operating characteristic curves (AUROC) than the Child-Pugh, MELD, and ICG-R15. Moreover, ALBI can predict PHLF bile leakage severity and occurrence. However, the initial goal of ALBI was the measurement of liver function that independently influences the survival in HCC patients. In the future, analysis of the grading and cut off valve of ALBI combined with radiology technology may improve the accuracy of PHLF occurrence prediction, which would benefit shared decision making (SDM).