Correlation analysis between albumin-bilirubin-gamma-glutamyltransferase score and prognosis in patients with hepatocellular carcinoma

Abstract

Abstract: Objective:To investigate the accuracy of the albumin-bilirubin (ALBI) score combined with gamma-glutamyltransferase (GGT) in constructing an ALBI-GGT score for predicting postoperative prognosis in patients with hepatocellular carcinoma (HCC) undergoing curative liver resection.
Methods:Clinical data of 154 HCC patients who underwent curative liver resection from March 2018 to December 2023 were retrospectively collected. Univariate and multivariate Cox model analyses were performed to identify factors associated with patient prognosis. The ALBI-GGT score was constructed based on the regression coefficients of the ALBI score and GGT. The concordance index (C-index), Akaike information criterion (AIC), and Bayesian information criterion (BIC) were used to evaluate and compare the goodness-of-fit and complexity of the ALBI-GGT score. Kaplan-Meier survival curves and restricted cubic spline analysis were employed to examine the relationship between the ALBI-GGT score and patient survival status. Receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used to assess the ALBI-GGT score's ability in predicting the risk of postoperative death at 1, 3, and 5 years.
Results:The follow-up time for the 154 HCC patients ranged from 3.0 to 60.0 months, with a median survival time of 34.2 months. The 1-year, 3-year, and 5-year survival rates were 86.4%, 49.6%, and 41.8%, respectively. Univariate and multivariate Cox regression analyses identified both the ALBI score and GGT as independent risk factors for postoperative mortality in HCC patients (P<0.05). The likelihood ratio test indicated no significant interaction (HR=1.136, P=0.091), suggesting that the effects of the two factors are independent and additive.The ALBI-GGT score (1.643×ALBIs core+0.755×GGT) yielded C-index, AIC, and BIC values of 0.813, 703.636, and 706.102, respectively. The overall survival rate of patients with a high ALBI-GGT score was significantly lower than that of the low-score group (P<0.05). The restricted cubic spline model demonstrated a significant nonlinear relationship for the ALBI-GGT score (P<0.001). The score showed excellent predictive performance for postoperative mortality, with AUC of 0.820, 0.917, and 0.924 at 1, 3, and 5 years, respectively.
Conclusion:The ALBI-GGT score effectively integrates information related to liver function and tumor biology. It predicts the prognosis of HCC patients after curative liver resection more accurately than the ALBI score or GGT alone, and it is helpful for achieving more refined postoperative risk stratification and individualized management.

Key words: Hepatocellular carcinoma, Albumin, Bilirubin, Gamma-glutamyltransferase, Prognosis

Chen Yan, Chen Li, Ni Jinlong, Zhu Mingfang, Li Hongbing. Correlation analysis between albumin-bilirubin-gamma-glutamyltransferase score and prognosis in patients with hepatocellular carcinoma[J]. Electronic Journal of Liver Tumor, 2026, 13(2): 9-17.

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