术前外周血嗜酸性粒细胞升高对肝细胞癌根治术预后的影响

Effect of Eosinophils in peripheral blood on prognosis after hepatectomy for hepatocellular carcinoma

目的探讨外周血嗜酸性粒细胞(eosinophils,EOS)升高对肝细胞癌(hepatocellular carcinoma,HCC)根治性切除术预后的影响。方法回顾性分析广西医科大学附属肿瘤医院2011年1月至2013年12月初诊为HCC并接受根治性肝切除治疗患者的临床资料,共431例患者纳入研究,按EOS表达分为术前EOS升高组(≥0.5×109/L)56例和EOS正常组(<0.5×109/L)375例。采用倾向性评分匹配法平衡两组临床基线资料,Kaplan-Meier法进行生存分析,Cox比例风险模型评估患者死亡的独立危险因素。结果倾向性评分匹配前EOS正常组和升高组患者1年、3年、5年生存率分别为78.9%、54.3%、38.0%和82.1%、49.9%、30.1%,两组生存曲线比较差异无统计学意义(χ2=0.614,P=0.341);按1:1倾向性评分匹配后分别获得47例患者,EOS正常组和升高组1年、3年、5年生存率分别为85.1%、61.6%、31.2%和87.2%、50.0%、25.1%,两组生存曲线比较差异亦无统计学意义(χ2=0.601,P=0.438)。结论术前EOS升高对HCC患者总生存率无影响。

Objective To investigate the significance of increased eosinophils（EOS）in peripheral blood on the prognosis after radical resection for hepatocellular carcinoma（HCC）,providing a reference for determining the prognosis of patients after radical resection for liver cancer. Methods Clinical data were retrospectively analyzed for patients with newly diagnosed HCC undergoing radical hepatectomy in Affiliated Tumor Hospital Guangxi Medical University between January 2011 and December 2013.Patients（431）were divided into2 groups：a group that showed preoperative EOS increase（n=56）,and a group that showed normal EOS（n=375）. Imbalance in clinical data between the two groups was eliminated using propensity score matching（PSM）.Survival analysis was conducted using the KaplanMeier method. Independent risk factors for cumulative survival rate were determined using Cox proportional hazards modeling.Results Before PSM,cumulative survival rates at 1,3 and 5 years were 78.9%,54.3%,and 38.0% in the normal EOS group;the corresponding values in the EOS increase group were 82.1%,49.9%,and 30.1%（χ2=0.614,P=0.341）.After PSM（1∶1）,47 patient pairs were obtained,and the cumulative survival rates were 85.1%,61.6%,and 31.2% in the normal EOS group,compared to 87.2%,50.0%,and 25.1% in the EOS increase group（χ2=0.601,P=0.438）. Conclusion Preoperative increase in EOS in peripheral blood has no effect on overall survival rate in HCC patients.