Kronik hepatit B ve B+D kaynaklı sirozda, hepatoselüler karsinom gelişiminin öngörülmesinde ALBI ve PALBI skorlamalarının prediktif değeri

Amaç: Hepatoselüler karsinom (HCC), dünya çapında kanser kaynaklı ölümlerin ikinci en yaygın nedenidir. HCC, çoğu olguda sirotik karaciğer dokularında gelişir. HCC'nin teşhisinde ve tedavisinde yeni gelişmeler olmasına rağmen, 5 yıllık sağkalım oranı halen % 12' nin altındadır. Bu nedenle, erken tanı ve agresif yaklaşım, HCC tedavisi için en önemli nokta haline gelmiştir. Bu çalışmanın amacı, kronik hepatit B ve kronik hepatit B + D kaynaklı sirozda HCC gelişiminde albumin-bilirubin indeksi (ALBI) ve Platelet-albumin-bilirubin indeksinin (PALBI) prediktivitelerinin değerlendirilmesidir. Materyal ve Metod: Çalışmaya 2004-2019 yılları arasında Demiroğlu Bilim Üniversitesi Tıp Fakültesi Gastroenteroloji bölümüne başvuran kronik hepatit B ve kronik hepatit B + D ‘ye bağlı karaciğer sirozu bulunan 331 hasta dahil edildi. Hastalar HCC olan ve olmayan hastalar olmak üzere iki ana gruba ayrıldı. Hastaların demografik verileri ve vücut kitle indeksleri istatistiksel olarak analiz edildi. Hastaların Child ve MELD skorları ile laboratuvar bulguları gruplar için ayrı ayrı kaydedildi ve incelendi. Ortalama ALBI ve PALBI değerleri her iki hasta grubu için ayrı ayrı hesaplandı. Son aşamada HCC gelişimi ile ALBI ve PALBI arasındaki ilişki ve bu skorların prediktif değerleri değerlendirildi. Bulgular: Hastaların yaş ortalaması 51.3 ± 9.18, ortalama ağırlığı 77.7 ± 13.08 kg, ortalama boyu 165 ± 18 cm, ortalama vücut kitle indeksi (BKİ) ise 30.04 ± 11.65 idi. HCC grubu 115 hastadan ve HCC olmayan siroz grubu 216 hastadan oluşmaktaydı. Ortalama ALBI ve PALBI skor değerleri, HCC grubu hastalarda, HCC olmayan sirozlu hasta grubuna göre anlamlı derecede düşüktü (p <0,001). Receiver operating characteristics (ROC) analizi yapıldığında, eğri altındaki alan (AUC) ALBI skoru için 0.775 ve PALBI skoru için 0.733 olarak saptandı. Sonuç: ALBI ve PALBI skorları HCC’ li hastalarda sağkalım ve prognozun öngörülmesi amacı ile geliştirilmiştir. Çalışmamızda, ALBI ve PALBI skorlarının HCC ‘de sağkalım ve prognoz tahimininin yanısıra, sirozlu hastalarda HCC gelişimi öngörüsünde de kullanışlı belirteçler olabilecekleri sonucuna varıldı.

Anahtar Kelimeler:

ALBI, PALBI, Hepatocellular carcinoma, Siroz

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