Predictive Value of Neutrophil-to-lymphocyte Ratio,and Alpha-fetoprotein Combined with the Albumin-bilirubin Score on the Prognosis of Patients with Massive Liver Cancer Treated with Transarterial Chemoembolization Combined with Microwave Ablation

WANG Xiuzhen; TAN Ying; CUI Xinjiang; HAN Jinlong; XING Hui

doi:10.3639/i.issn.2095-3097.2025.01.015

Abstract：Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR),and alpha-fetoprotein(AFP)combined with the albumin-bilirubin(ALBI)score in the prognosis of patients with massive liver cancer treated by transarterial chemoembolization(TACE)combined with microwave ablation.Methods Clinical data of 106 patients with massive liver cancer who underwent TACE combined microwave ablation at the Affiliated Hospital of Shandong Second Medical University from November 2021 to October 2023 were retrospectively analyzed.According to the 1-year prognosis after surgery,they were divided into the good prognosis group and poor prognosis group.General information and peripheral blood NLR and AFP were compared between groups,and the ALBI score was calculated.Multivariate logistic regression was used to analyze the factors affecting the poor prognosis of patients with massive liver cancer treated with TACE combined with microwave ablation.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR,AFP and ALBI score in the prognosis of massive liver cancer treated with TACE combined with microwave ablation.Results In the study,31 patients with recurrence were included in the poor prognosis group,and the remaining patients were included in the good prognosis group.Patients in the poor prognosis group were significantly older than those in the good prognosis group,and their NLR,AFP and ALBI scores were significantly higher than those in the good prognosis group(P<0.05).Multivariate unconditional logistic regression analysis found that age,NLR,AFP,and ALBI score were all risk factors for the poor prognosis.ROC curve analysis Results showed that the area under the curve(AUC)of NLR,AFP,and ALBI score in predicting the postoperative prognosis was 0.774,0.831,and 0.711 respectively.The AUC of the combined prediction of the three was 0.897,and their sensitivity and specificity were 0.742 and 0.960 respectively.Conclusion Age,NLR,AFP,and ALBI scores are all influencing factors for the poor prognosis of massive liver cancer treated with TACE combined with microwave ablation.Peripheral blood NLR,AFP combined with ALBI scores have a high predictive value for the prognosis.