The Predictive Value of the Combination of Serum RBP4, ALP, IL-1β for Postoperative Recurrence of Intrahepatic Bile Duct Stones.

Objective: To investigate the predictive value of serum retinol-binding protein (RBP4), alkaline phosphatase (ALP), and interleukin (IL)-1β for postoperative recurrence of intrahepatic bile duct stones (IBDS). Methods: This retrospective study included 320 patients with intrahepatic bile duct stones (IBDS) admitted to our hospital from May 2020 to May 2022, all of whom underwent laparoscopic choledocholithotomy combined with choledochoscopy. Patients were divided into a recurrence group and a non-recurrence group based on their postoperative status. Serum levels of RBP4 and IL-1β were measured by ELISA; liver function indicators including ALP were analyzed using a biochemical analyzer; levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were also detected by ELISA; toll-like receptor 4 (TLR4) and thyroid-stimulating hormone (TSH) were measured by radioimmunoassay.Pearson correlation analysis was performed to assess the relationships between serum RBP4, ALP, IL-1β and laboratory indicators. Multivariate logistic regression analysis was used to identify factors influencing postoperative recurrence of IBDS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum RBP4, ALP, and IL-1β for IBDS recurrence after surgery. Results: The levels of serum RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). Pearson correlation analysis showed that serum RBP4, ALP, and IL-1β were all positively correlated with TNF-α, TLR4, and TSH (P < 0.05). Multivariate logistic regression analysis identified RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH as independent risk factors for postoperative recurrence of IBDS (P < 0.05).According to ROC curve analysis showed that the area under the curve (AUC) for serum RBP4 in predicting postoperative recurrence of IBDS was 0.844, for serum ALP was 0.822, and for serum IL-1β was 0.732. The combined detection of RBP4, ALP, and IL-1β yielded an AUC of 0.892, which was superior to the predictive performance of each marker alone (Z = 2.654, Z = 2.668, Z = 2.650; all P < 0.05). Conclusion: Serum levels of RBP4, ALP, and IL-1β are significantly elevated in patients with IBDS, and their combined detection can enhance the predictive value for postoperative recurrence of IBDS.