摘要
目的研究术前肝纤维化指数与肝癌肝切除患者预后的相关性。方法对2009年10月至2014年12月中山大学附属第五医院肝胆外科77例肝癌肝切除患者的临床资料进行回顾性分析。根据术前肝纤维化指数将患者分为低指数组(肝纤维化指数≤5.4,n=35)和高指数组(肝纤维化指数〉5.4,n=42),分析两组患者临床病理学参数及术后无瘤生存的统计学差异。以Cox回归模型对其术后复发情况进行相关因素分析。结果低指数与高指数两组患者性别分布(35/0比29/13)、肝硬化类型(23/12比14/28)、肿瘤数目(35/0比26/16)、最大直径(31/4比23/19)、血管侵犯(32/3比26/16)、切缘阳性(35/0比36/6)、肝静脉或门静脉癌栓情况(35/0比29/13)、HBVDNA手术前后数量级变化情况(23/12比15/27)及术后复发率差异具有统计学意义(P〈0.05)。肝纤维化指数〉5.4组无瘤生存率(71.4%、33.7%、22.4%)低于肝纤维化指数≤5.4组(94.3%、46.2%、46.2%)(P〈0.05)。Cox回归分析提示术前甲胎蛋白异质体L3≥10%、肝纤维化指数〉5.4、术前肿瘤数目〉3个是肝癌术后复发的独立危险因素(P〈0.05)。结论术前肝纤维化指数〉5.4是影响肝癌肝切除患者术后复发的独立危险因素,对于预测肝癌肝切除患者的预后具有一定的价值。
Objective To study the correlation between liver fibroindex and prognosis of hepatoeel- lular carcinoma after hepatectomy. Methods The clinical data of 77 patients with hepatocellular carcinoma who underwent hepatectomy at the 5th Hospital Affiliated to Sun Yat-sen University from 2009 October to 2014 December were analyzed retrospectively. Using data from preoperative Fibroindex, these patients were divided into 2 groups, Group 1 : Fibroindex ≤5.4, and Group 2: Fibroindex 〉 5.4. The clinical pathologi- cal parameters and postoperative disease free survival rates in these groups were analyzed. The Cox ratio risk pattern analysis was used for factors correlating recurrence. Results The parameters in the 2 groups which included sex (35/0 vs 29/13 ), type of cirrhosis (23/12 vs 14/28 ) , numbers of tumor (35/0 vs 26/16) , maximal diameter of tumor (31/4 vs 23/19), vascular invasion status (32/3 vs 26/16), resection margin status (35/0 vs 36/6), hepatic vein/portal vein tumor thrombus status (35/0 vs 29/13), perioperative change of HBV DNA levels (23/12 vs 15/27)were correlated with postoperative recurrence, and they all showed significant differences (P 〈 0.05 ). Disease free survival rate in Group 2 was lower than Group 1 (71.4%, 33.7% , 22.4% vs 94.3% , 46.2% , 46.2% , P 〈 0. 05). The Cox regression analysis showed Fibroindex 〉 5.4, AFP-L3% ≥10% , and number of tumor 〉 3 to be independent predictors of poor dis- ease-free survival after hepatectomy for hepatoeellular carcinoma (P 〈 0.05). Conclusions Preoperative Fibroindex 〉 5.4 was an independent adverse predictor of poor disease-free survival. It was valuable to pre- dict postoperative recurrence in hepatocellular carcinoma patients.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第4期223-226,共4页
Chinese Journal of Hepatobiliary Surgery
基金
广东省博士启动基金(10451008901004816)
关键词
肝细胞癌
肝纤维化指数
术后复发
Hepatocellular carcinoma
Fibroindex
Postoperative recurrence