HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Development and validation of six-parameter laboratory-based prognostic model (APHPBA score) for patients undergoing hepatectomy for hepatitis B virus-related hepatocellular carcinoma.
СтатьяМногоцентровое исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Liu Yi-Fei, Wang Hong, Zhou Ya-Hao, Li Xin, Du Zu-Chao, Tang Zi-Jie, Zhai Wen-Long, Zeng Yong-Yi, Chen Ting-Hao, Diao Yong-Kang, Tu Zi-Chao, Gu Li-Hui, Wu Han, Shen Feng, Wang Ming-Da, Wang Lai, Wu Fei, Yang Tian, Eastern HepatoBiliary Alliance (EHBA) group
Аннотация
PURPOSE: HBV-related HCC shows prognostic heterogeneity not fully captured by current staging. We developed and validated the APHPBA score, a laboratory-based model for patients undergoing curative hepatectomy.
METHODS: This multicenter retrospective study included patients who underwent hepatectomy for HBV-related HCC between 2018 and 2023. The APHPBA score incorporated six routine preoperative parameters: alpha-fetoprotein (AFP), protein induced by vitamin K absence-II (PIVKA-II), HBV-DNA, prothrombin time (PT), bilirubin (BIL), and albumin (ALB). Patients were stratified into three stages: Stage I (0-1 point), Stage II (2-3 points), and Stage III (4-6 points). Prognostic performance was compared with conventional systems using Cox regression and time-dependent receiver operating characteristic (ROC) analyses.
RESULTS: Among 1100 patients, 36.7 % were Stage I, 48.5 % Stage II, and 14.8 % Stage III. After a median follow-up of 48.0 months, 5-year overall survival was 63.4 %, 43.3 %, and 26.4 % across Stages I-III (P < 0.001). The APHPBA score remained independently associated with overall survival after adjustment for clinicopathologic factors and consistently outperformed established staging systems with higher time-dependent AUCs.
CONCLUSION: The APHPBA score provides robust postoperative risk stratification for HBV-related HCC using routinely available laboratory parameters.
METHODS: This multicenter retrospective study included patients who underwent hepatectomy for HBV-related HCC between 2018 and 2023. The APHPBA score incorporated six routine preoperative parameters: alpha-fetoprotein (AFP), protein induced by vitamin K absence-II (PIVKA-II), HBV-DNA, prothrombin time (PT), bilirubin (BIL), and albumin (ALB). Patients were stratified into three stages: Stage I (0-1 point), Stage II (2-3 points), and Stage III (4-6 points). Prognostic performance was compared with conventional systems using Cox regression and time-dependent receiver operating characteristic (ROC) analyses.
RESULTS: Among 1100 patients, 36.7 % were Stage I, 48.5 % Stage II, and 14.8 % Stage III. After a median follow-up of 48.0 months, 5-year overall survival was 63.4 %, 43.3 %, and 26.4 % across Stages I-III (P < 0.001). The APHPBA score remained independently associated with overall survival after adjustment for clinicopathologic factors and consistently outperformed established staging systems with higher time-dependent AUCs.
CONCLUSION: The APHPBA score provides robust postoperative risk stratification for HBV-related HCC using routinely available laboratory parameters.