Trends of alkaline phosphatase to prealbumin ratio in patients with hepatitis B linked to hepatocellular carcinoma development.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastroenterology Pub Date : 2025-01-14 DOI:10.3748/wjg.v31.i2.99349

Wen-Chong Zhen, Jing Sun, Xue-Ting Bai, Qian Zhang, Zi-Han Li, Yi-Xin Zhang, Rong-Xuan Xu, Wei Wu, Zhi-Han Yao, Chun-Wen Pu, Xiao-Feng Li

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Abstract

Background: Chronic hepatitis B often progresses silently toward hepatocellular carcinoma (HCC), a leading cause of mortality worldwide. Early detection of HCC is crucial, yet challenging.

Aim: To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio (APR) in hepatitis B progression to HCC.

Methods: Data from 4843 patients with hepatitis B (January 2015 to January 2024) were analyzed. HCC incidence rates in males and females were compared using the log-rank test. Data were evaluated using Kaplan-Meier analysis. The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time. Furthermore, Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.

Results: The incidence of HCC was higher in males. To ensure the model's normality assumption, this study applied a logarithmic transformation to APR, yielding ratio. Ratio levels were higher in females (t = 5.26, P < 0.01). A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males (95%CI: 1.653-2.431) and a 2.273-fold higher risk in females (95%CI: 1.620-3.190).

Conclusion: Males are more prone to HCC, while females have higher APR levels. Despite no baseline APR link, rising APR indicates a higher HCC risk.

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乙型肝炎患者碱性磷酸酶与前白蛋白比率的变化趋势与肝细胞癌的发展有关。

背景：慢性乙型肝炎通常悄无声息地发展为肝细胞癌（HCC），这是世界范围内死亡的主要原因。早期发现HCC至关重要，但也具有挑战性。目的：探讨碱性磷酸酶与白蛋白前比值（APR）的动态变化在乙型肝炎进展为HCC中的作用。方法：对2015年1月~ 2024年1月4843例乙型肝炎患者的资料进行分析。使用log-rank检验比较男性和女性的HCC发病率。采用Kaplan-Meier分析对数据进行评价。采用线性混合效应模型跟踪APR水平随时间的波动。此外，采用纵向和生存数据联合建模来研究APR与HCC风险之间的时间关系。结果：男性HCC发生率较高。为了保证模型的正态性假设，本研究对收益率APR进行了对数变换。女性的比值水平较高（t = 5.26, P < 0.01）。每增加1个单位，男性发生HCC的风险增加2.005倍（95%CI: 1.653-2.431），女性发生HCC的风险增加2.273倍（95%CI: 1.620-3.190）。结论：男性更易发生HCC，而女性APR水平较高。尽管没有基线APR联系，但APR升高表明HCC风险较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

7.80

自引率

4.70%

发文量

464

审稿时长

2.4 months

期刊介绍： The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.