Newcastle-Ottawa quality assessment scale.

Background
Numerous studies have reported the association between preoperative albumin-bilirubin (ALBI) grade and survival outcomes in patients with cholangiocarcinoma (CCA). However, the results are inconsistent. Therefore, we conducted a meta-analysis to comprehensively evaluate the relationship between ALBI grade and prognosis of CCA patients.
Methods
We retrieved the databases (Pubmed,Embase and Web of science) to search articles about the association of ALBI grade with prognostic value in CCA patients. Hazard ratios (HR) and 95% confidence intervals (CI) were used to summarize survival outcomes. STATA 12.0 was used to implement the data analyses.
Results
11 studies from 10 articles comprising 2841 patients were included in the meta-analysis. The pooled results showed that high ALBI grade was significantly associated with poor overall survival (OS) (HR: 1.75, 95% CI: 1.32–2.31) and relapse-free survival(RFS)(HR:1.95;95%CI:1.37–2.13). Subgroup analysis further showed that high ALBI grade had better predictive value for Asian population(HR:1.92;95%CI:1.46–2.51). Sensitivity analysis indicated that the results of the meta-analysis were stable.
Conclusions
High ALBI grade predicted adverse survival outcomes in CCA patients. ALBI grade may be an efficient and convenient prognostic indicator in CCA patients for Asian population.

背景
多项研究已报道胆管癌（cholangiocarcinoma，CCA）患者术前白蛋白-胆红素（albumin-bilirubin，ALBI）分级与生存结局的关联，但所得结果并不一致。为此，本研究开展一项荟萃分析，以全面评估ALBI分级与CCA患者预后的相关性。
方法
我们检索PubMed、Embase及Web of Science数据库，筛选关于ALBI分级与CCA患者预后价值关联的相关文献。采用风险比（Hazard ratios, HR）及95%置信区间（95% confidence intervals, CI）汇总生存结局数据，使用STATA 12.0软件完成数据分析。
结果
本荟萃分析共纳入10篇文献中的11项研究，涉及2841例患者。合并分析结果显示，高ALBI分级与较差的总生存期（overall survival, OS）（HR=1.75，95%CI：1.32~2.31）及无复发生存期（relapse-free survival, RFS）（HR=1.95，95%CI：1.37~2.13）显著相关。亚组分析进一步表明，高ALBI分级对亚洲人群具有更优的预测价值（HR=1.92，95%CI：1.46~2.51）。敏感性分析证实，本荟萃分析结果具有良好的稳定性。
结论
高ALBI分级可预测CCA患者不良生存结局，ALBI分级或可作为亚洲人群CCA患者高效便捷的预后评估指标。