Construction and validation of a prognostic prediction model based on albumin-bilirubin grade after resection of hepatocellular carcinoma

Table 1 General characteristics of study participants, n (%)/mean ± SD

Variables	All patients (n = 596)
Sex (male/female)	460 (77.18)/136 (22.82)
Age (years)	56.50 ± 9.53
BMI (kg/m2)	24.61 ± 2.52
Smoking history (no/yes)	398 (66.78)/198 (33.22)
Alcohol use (no/yes)	387 (64.93)/209 (35.07)
History of diabetes (no/yes)	503 (84.40)/93 (15.60)
Family history (no/yes)	527 (88.42)/69 (11.58)
History of liver cirrhosis (no/yes)	363 (60.90)/233 (39.09)
History of hepatitis B (no/yes)	307 (51.51)/289 (48.49)
Tumor size (cm)	4.51 ± 1.02
Tumors number (single/multiple)	429 (71.98)/167 (28.02)
Portal hypertension (no/yes)	500 (83.89)/96 (16.11)
Vascular invasion (no/yes)	458 (76.85)/138 (23.15)
Perineural invasion (no/yes)	540 (90.60)/56 (9.40)
Degree of differentiation (well/moderate/poor)	123 (20.64)/349 (58.56)/124 (20.81)
Child-Pugh class (A/B)	450 (75.50)/146 (24.50)
AFP (μg/L)	299.24 ± 78.89
DCP (mAU/mL)	97.97 ± 30.24
ALT (U/L)	40.34 ± 10.07
AST (U/L)	42.17 ± 9.82
TBIL (μmol/L)	16.73 ± 4.10
Albumin (g/L)	38.96 ± 5.74
ALBI grade (1/2/3)	248 (41.61)/340 (57.05)/8 (1.34)

BMI: Body mass index; AFP: Preoperative alpha-fetoprotein; DCP: Des-gamma-carboxy prothrombin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; ALBI: Albumin-bilirubin.

Table 2 Variable assignment and coding

Variables	Assignment of value
Sex	Female = 0, male = 1
Age	Continuous
Body mass index	Continuous
Smoking history	No = 0, yes = 1
Alcohol use	No = 0, yes = 1
History of diabetes	No = 0, yes = 1
Family history	No = 0, yes = 1
History of liver cirrhosis	No = 0, yes = 1
History of hepatitis B	No = 0, yes = 1
Tumor size	Continuous
Tumor number	Single = 0, multiple = 1
Portal hypertension	No = 0, yes = 1
Vascular invasion	No = 0, yes = 1
Perineural invasion	No = 0, yes = 1
Degree of differentiation	Well-differentiated = 0, moderately differentiated = 1, poorly differentiated = 2
Child-Pugh class	Class A = 0, class B = 1
AFP	Continuous
DCP	Continuous
ALT	Continuous
AST	Continuous
TBIL	Continuous
Albumin	Continuous
ALBI grade	Grade 1 = 0, grade 2/3 = 1

AFP: Preoperative alpha-fetoprotein; DCP: Des-gamma-carboxy prothrombin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; ALBI: Albumin-bilirubin.

Table 3 Univariate regression analysis of recurrence-free survival in patients after hepatocellular carcinoma resection

Variables	β	SE	Wald	P value	HR (95%CI)
Sex	0.452	0.197	5.261	0.022	1.571 (1.068-2.312)
Age	0.023	0.008	7.802	0.005	1.023 (1.007-1.039)
Body mass index	-0.010	0.028	0.118	0.732	0.990 (0.937-1.047)
Smoking history	-0.118	0.160	0.544	0.461	0.888 (0.649-1.216)
Alcohol use	-0.044	0.156	0.179	0.778	0.957 (0.705-1.299)
History of diabetes	0.110	0.208	0.279	0.597	1.116 (0.742-1.679)
Family history	0.180	0.215	0.701	0.402	1.197 (0.785-1.826)
History of liver cirrhosis	0.398	0.148	7.247	0.007	1.489 (1.114-1.989)
History of hepatitis B	-0.013	0.148	0.008	0.929	0.987 (0.739-1.318)
Tumor size	0.226	0.073	9.536	0.002	1.254 (1.086-1.447)
Tumor number	0.373	0.156	5.714	0.017	1.452 (1.069-1.972)
Portal hypertension	0.182	0.197	0.851	0.356	1.199 (0.815-1.764)
Vascular invasion	0.385	0.164	5.519	0.019	1.469 (1.066-2.026)
Perineural invasion	0.029	0.255	0.013	0.910	1.029 (0.625-1.695)
Degree of differentiation	0.282	0.117	5.795	0.016	1.326 (1.054-1.668)
Child-Pugh class	-0.189	0.174	1.172	0.279	0.828 (0.589-1.165)
AFP	0.004	0.001	17.381	< 0.001	1.004 (1.002-1.006)
DCP	-0.001	0.002	0.379	0.538	0.999 (0.994-1.003)
ALT	-0.002	0.008	0.043	0.835	0.998 (0.984-1.013)
AST	-0.002	0.008	0.071	0.790	0.998 (0.983-1.013)
TBIL	-0.011	0.019	0.357	0.55	0.989 (0.953-1.026)
Albumin	-0.025	0.013	3.965	0.046	0.975 (0.951-1.000)
ALBI grade	0.576	0.157	13.514	< 0.001	1.779 (1.309-2.419)

HR: Hazard ratio; CI: Confidence interval; AFP: Preoperative alpha-fetoprotein; DCP: Des-gamma-carboxy prothrombin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; ALBI: Albumin-bilirubin.

Table 4 Multivariate regression analysis of recurrence-free survival in patients after hepatocellular carcinoma resection

Variables	β	SE	Wald	P value	HR (95%CI)
Sex	0.291	0.202	2.080	0.149	1.338 (0.901-1.998)
Age	0.017	0.008	4.364	0.037	1.017 (1.001-1.033)
History of liver cirrhosis	0.197	0.152	1.667	0.197	1.217 (0.903-1.640)
Tumor size	0.232	0.077	9.098	0.003	1.261 (1.085-1.466)
Tumor number	0.410	0.158	6.743	0.009	1.507 (1.106-2.054)
Vascular invasion	0.285	0.168	2.893	0.089	1.330 (0.957-1.849)
Degree of differentiation	0.215	0.121	3.140	0.076	1.240 (0.977-1.572)
AFP	0.003	0.001	10.745	0.001	1.003 (1.001-1.005)
Albumin	0.037	0.022	2.673	0.102	1.037 (0.993-1.084)
ALBI grade	0.796	0.277	8.276	0.004	2.216 (1.289-3.812)

HR: Hazard ratio; CI: Confidence interval; AFP: Preoperative alpha-fetoprotein; ALBI: Albumin-bilirubin.