术前体质量指数对肝细胞性肝癌患者预后的影响

Impact of pre-operation body mass index on prognosis of hepatocellular carcinoma

目的研究探讨术前体质量指数（BMI）对肝细胞性肝癌术后预后的影响。方法回顾性分析了1998~2005年105例肝细胞性肝癌术后的体质量指数资料,按BMI将患者分为低体质量、正常、高体质量和肥胖4组。采用生存分析对不同体质量指数组患者术后的预后进行综合比较分析。结果与正常体质量组相比,低体质量组的甲胎蛋白水平、肿瘤大小、分化程度在死亡风险、肿瘤再发及转移上的差异有显著性（P〈0.01）。单因素生存分析结果表明低体质量组的总体生存率有显著的下降（P〈0.001）。多因素预后分析显示体质量指数、肿瘤大小、肿瘤分级和甲胎蛋白水平可以做为判断预后的独立因素（P〈0.05）。结论低体质量组患者的总体生存率、无再发和无转移生存时间有明显的下降。体质量指数分级是判断原发性肝癌术后预后的一个独立因素。

Objective Given the information regarding the impact of BMI on prognosis for hepatocellular carcinoma after surgery,to examine the relationship between body mass index（BMI） and hepatocellular carcinoma after surgery.Methods We compared clinic BMI imformation of 105 patients from 1998 to 2005;multivariate analysis was used to determine if BMI significantly predicted recurrence and overall survival time.Results In comparison with normal group,there were statistical difference in AFP,tumor size,differentiation degree（P0.01）,in survival analysis,in comparison with under-weight group,we could found the hazard ratio was less than one,in the risk of death,recurrence and metastasis.In univariate survival analysis,under-weight group had a significant decrease in overall survival（P0.001）.When Cox regression model was applied to multivariate analysis,we could found BMI grades,tumor size,differentiation degree and AFP could be significant independent prognosis factors（P0.05）.Conclusions Under-weight group had a significant decrease in overall survival rate,recurrence-free and metastasis-free survival.BMI grades could be significant independent prognosis factors.