Prediction and analysis of albumin-bilirubin score combined with liver function index and carcinoembryonic antigen on liver metastasis of colorectal cancer

doi:10.4240/wjgs.v16.i6.1670

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Jun 27, 2024 (publication date) through Jun 29, 2024

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Jun 27, 2024; 16(6): 1670-1680
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1670

Table 1 Baseline data between liver metastasis group and non-liver metastasis group (n = 195)

Index	Liver metastases group (n = 70)	Non-liver metastases group (n = 125)	P value
Age (mean ± SD, yr)	58.3 ± 12.5	61.7 ± 12.0	0.067
Gender, n (%)			0.865
Man	40 (57.1)	73 (58.4)
Female	30 (42.9)	52 (41.6)
Primary tumor location, n (%)			0.042
Colon	38 (54.3)	49 (39.2)
Rectum	32 (45.7)	76 (60.8)
BMI, M (P₂₅, P₇₅), kg/m²	22.5 (21.4, 24.7)	22.1 (20.2, 25.0)	0.28
TBIL, M (P₂₅, P₇₅), μmol/L	14.9 (11.6, 24.7)	12.8 (9.4, 16.9)	0.001
DBIL, M (P₂₅, P₇₅), μmol/L	7.2 (4.3, 10.6)	3.3 (2.3, 5.4)	< 0.001
IBIL, M (P₂₅, P₇₅), μmol/L	9.3 (5.2, 14.3)	8.8 (6.0, 12.1)	0.642
ALT, M (P₂₅, P₇₅), U/L	31.5 (16.0, 54.8)	17.0 (10.0, 25.0)	< 0.001
AST, M (P₂₅, P₇₅), U/L	40.0 (27.8, 87.3)	20.0 (16.0, 25.5)	< 0.001
AST/ALT, M (P₂₅, P₇₅)	1.6 (1.1, 2.2)	1.4 (0.9, 1.7)	0.005
TP, M (P₂₅, P₇₅), g/L	65.1 (58.9, 70.6)	69.4 (64.3, 73.4)	0.001
ALB, M (P₂₅, P₇₅), g/L	36.3 (29.5, 40.2)	41.4 (38.3, 44.1)	< 0.001
GLO, M (P₂₅, P₇₅), g/L	29.3 (24.7, 33.5)	28.3 (24.0, 31.0)	0.124
A/G (mean ± SD)	1.2 ± 0.4	1.5 ± 0.3	< 0.001
GGT, M (P₂₅, P₇₅), U/L	59.0 (25.8, 148.0)	18.0 (13.0, 25.5)	< 0.001
ALP, M (P₂₅, P₇₅), U/L	122.5 (77.5, 211.0)	76.0 (63.0, 90.5)	< 0.001
AFP, M (P₂₅, P₇₅), μg/L	2.6 (1.6, 3.4)	2.5 (1.8, 3.2)	0.845
CEA, M (P₂₅, P₇₅), μg/L	79.5 (12.5, 476.0)	2.9 (1.8, 5.9)	< 0.001
CA125, M (P₂₅, P₇₅), U/mL	21.3 (11.0, 54.7)	11.1 (7.9, 16.7)	< 0.001
CA19-9, M (P₂₅, P₇₅), U/mL	85.5 (17.3, 801.7)	10.9 (7.5, 17.0)	< 0.001
ALBI score, M (P₂₅, P₇₅)	-2.3 (-2.7, -1.6)	-2.8 (-3.0, -2.6)	< 0.001

BMI: Body mass index; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TP: Total protein; ALB: Albumin; GLO: Globulin; A/G: Albumin/globulin; GGT: Gamma-glutamyltransferase; ALP: Alkaline phosphatase; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; CA125: Carbohydrate antigen 125; ALBI: Albumin bilirubin.

Table 2 Baseline data between modeling group and validation group (n = 195)

Index	Modeling group (n = 130)	Validation group (n = 65)	P value
Age (mean ± SD, yr)	60.3 ± 11.8	60.8 ± 31.2	0.772
Gender, n (%)			0.473
Man	73 (56.2)	40 (61.5)
Female	57 (43.8)	25 (38.5)
Primary tumor location, n (%)			0.222
Colon	62 (47.7)	25 (38.5)
Rectum	68 (52.3)	40 (61.5)
BMI, M (P₂₅, P₇₅), kg/m²	22.3 (20.3, 24.9)	22.0 (20.6, 25.0)	0.992
TBIL, M (P₂₅, P₇₅), μmol/L	13.3 (10.2, 18.0)	14.0 (9.6, 18.7)	0.825
DBIL, M (P₂₅, P₇₅), μmol/L	4.7 (2.8, 7.3)	3.9 (2.7, 7.1)	0.462
IBIL, M (P₂₅, P₇₅), μmol/L	8.7 (5.5, 11.9)	9.6 (5.6, 13.0)	0.412
ALT, M (P₂₅, P₇₅), U/L	17.5 (11.0, 31.0)	20.0 (11.0, 33.0)	0.518
AST, M (P₂₅, P₇₅), U/L	24.5 (17.0, 36.0)	24.0 (17.5, 38.0)	0.846
AST/ALT, M (P₂₅, P₇₅)	1.4 (0.9, 1.8)	1.4 (0.9, 1.9)	0.715
TP, M (P₂₅, P₇₅), g/L	68.3 (63.8, 72.9)	67.1 (61.8, 73.0)	0.348
ALB, M (P₂₅, P₇₅), g/L	40.1 (35.8, 43.5)	39.1 (36.8, 42.7)	0.666
GLO, M (P₂₅, P₇₅), g/L	28.7 (24.4, 32.4)	28.4 (24.0, 31.4)	0.556
A/G (mean ± SD)	1.4 ± 0.4	1.4 ± 0.3	0.991
GGT, M (P₂₅, P₇₅), U/L	22.5 (14.0, 52.3)	22.0 (14.5, 40.5)	0.828
ALP, M (P₂₅, P₇₅), U/L	80.0 (63.8, 111.0)	86.0 (67.0, 110.0)	0.606
AFP, M (P₂₅, P₇₅), μg/L	2.5 (1.7, 3.3)	2.7 (1.6,3.2)	0.607
CEA, M (P₂₅, P₇₅), μg/L	4.7 (2.0, 33.3)	5.3 (2.5, 35.3)	0.514
CA125, M (P₂₅, P₇₅), U/mL	12.6 (8.6, 23.2)	31.2 (9.1, 22.7)	0.792
CA19-9, M (P₂₅, P₇₅), U/mL	13.9 (8.1, 52.6)	15.2 (8.2, 52.4)	0.697
ALBI score, M (P₂₅, P₇₅)	-2.7 (-2.9, -2.3)	-2.7 (-2.9, -2.4)	0.522

Table 3 Multivariate Logistic regression analysis of factors influence liver metastasis of colorectal cancer

Variable	β	Error	Wald	Freedom	P value	OR	95%CI
Variable	β	Error	Wald	Freedom	P value	OR	Lower limit	Upper limit
ALT (U/L)	0.036	0.017	4.734	1	0.030	1.037	1.004	1.071
CEA (μg/L)	0.025	0.009	8.017	1	0.005	1.025	1.008	1.043
ALBI score	2.087	0.588	12.588	1	0.000	8.062	2.545	25.540
Constant term	3.047	1.555	3.839	1	0.050	21.058	-

ALT: Alanine aminotransferase; CEA: Carcinoembryonic antigen; ALBI: Albumin bilirubin; OR: Odds ratio; CI: Confidence interval.

Table 4 Diagnostic efficacy between individual and combined detection of alanine aminotransferase, carcinoembryonic antigen, and albumin bilirubin score in modeling group

Testing index	AUC	Sensitivity (%)	Specificity (%)	P value
ALT	0.704	58.0	85.0	< 0.001
CEA	0.897	84.0	87.5	< 0.00
ALBI score	0.825	84.0	72.5	< 0.001
ALT combined with CEA	0.896	80.0	912	< 0.00
ALT combined with ALBI score	0.858	80.0	78.7	< 0.001
CEA combined with ALBI score	0. 91	82.0	86.3	< 0.001
Combination of the three	0.921	78.0	95.0	< 0.001

ALT: Alanine aminotransferase; CEA: Carcinoembryonic antigen; ALBI: Albumin bilirubin; AUC: Area under the receiver operating characteristic curve.

Table 5 Diagnostic efficacy between individual and combined detection of alanine aminotransferase, carcinoembryonic antigen, and albumin bilirubin score in verification group

Testing index	AUC	Sensitivity (%)	Specificity (%)	P value
ALT	0.774	75.0	73.3	< 0.001
CEA	0.864	75.0	88.9	< 0.001
ALBI score	0.659	45.0	97.8	0.042
ALT combined with CEA	0.916	85.0	95.6	< 0.001
ALT combined with ALBI score	0.784	60.0	91.1	< 0.001
CEA combined with ALBI score	0.834	70.0	100.0	< 0.001
Combination of the three	0.918	85.0	95.6	< 0.001

ALT: Alanine aminotransferase; CEA: Carcinoembryonic antigen; ALBI: Albumin bilirubin; AUC: Area under the receiver operating characteristic curve.

Citation: Wang ZM, Pan SP, Zhang JJ, Zhou J. Prediction and analysis of albumin-bilirubin score combined with liver function index and carcinoembryonic antigen on liver metastasis of colorectal cancer. World J Gastrointest Surg 2024; 16(6): 1670-1680
URL: https://www.wjgnet.com/1948-9366/full/v16/i6/1670.htm
DOI: https://dx.doi.org/10.4240/wjgs.v16.i6.1670