The prognostic role of the AST/ALT ratio in hepatocellular carcinoma patients receiving thermal ablation combined with simultaneous TACE

Feihang Wang; Shanshan Gao; Mengfei Wu; Danyang Zhao; Huiyi Sun; Sothea Yav; Yi Chen; Zihan Zhang; Minjie Yang; Yi Dong; Jianhua Wang; Xiaolin Wang; Zhiping Yan; Lingxiao Liu

doi:10.1186/s12876-023-02719-1

The prognostic role of the AST/ALT ratio in hepatocellular carcinoma patients receiving thermal ablation combined with simultaneous TACE

BMC Gastroenterol. 2023 Mar 21;23(1):80. doi: 10.1186/s12876-023-02719-1.

Authors

Feihang Wang^#^{1

2}, Shanshan Gao^#^{1

2

3}, Mengfei Wu^#⁴, Danyang Zhao^{1

2}, Huiyi Sun^{1

2}, Sothea Yav^{1

2}, Yi Chen^{1

2}, Zihan Zhang^{1

2}, Minjie Yang^{1

2}, Yi Dong⁵, Jianhua Wang^{1

2}, Xiaolin Wang^{1

2}, Zhiping Yan^{6

7}, Lingxiao Liu^{8

9}

Affiliations

¹ Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
² National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
³ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
⁴ Department of CT&MRI, Third Hospital of Hebei Medical University, , Shijiazhuang, 050051, Hebei Province, China.
⁵ Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China. zhipingyan@fudan.edu.cn.
⁷ National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. zhipingyan@fudan.edu.cn.
⁸ Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No.180 Fenglin Road, Xuhui District, Shanghai, 200032, China. liulingxiao2022@163.com.
⁹ National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. liulingxiao2022@163.com.

^# Contributed equally.

Abstract

Background: To evaluate the prognostic value of the pre-treatment aspartate transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC) patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with simultaneous TACE.

Methods: The data for 117 patients were retrospectively analyzed in this study. The endpoint of prognosis was overall survival (OS). The Youden index was used to choose the optimal cut-off value of the pre-treatment AST/ALT ratio for OS prediction. Univariate and multivariate analyses were used to identify independent risk factors, then integrated to establish the nomogram.

Results: The AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with a higher AST/ALT ratio had poorer OS. The median OS for the high-value AST/ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5 months (P = 0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP, and tumor numbers were independent prognostic indicators for OS. The integrated nomogram showed higher predictive accuracy for OS (C-index 0.674, 95%CI: 0.600-0.748).

Conclusions: The preoperative AST/ALT ratio could be a prognostic indicator for HCC patients receiving thermal ablation combined with simultaneous TACE.

Keywords: Enzymes; Hepatocellular carcinoma; TACE; Thermal ablation.

MeSH terms

Alanine Transaminase
Aspartate Aminotransferases
Carcinoma, Hepatocellular* / pathology
Carcinoma, Hepatocellular* / surgery
Chemoembolization, Therapeutic*
Humans
Liver Neoplasms* / pathology
Liver Neoplasms* / surgery
Prognosis
Retrospective Studies
Treatment Outcome

Substances

Alanine Transaminase
Aspartate Aminotransferases