乙型肝炎相关性原发性肝癌的预后因素分析

Prognostic factors analysis of hepatitis B related primary liver cancer

目的探讨乙型肝炎相关性原发性肝癌的预后因素。方法回顾性分析2013年3月~2016年3月我院收治的100例乙型肝炎相关性原发性肝癌患者的临床资料,均接受手术切除及抗病毒治疗。结合患者术后的无瘤生存时间将100例患者分为对照组(n=50,生存时间>3年)与研究组(n=50,生存时间≤3年),分析其预后因素。结果两组的性别、腹水、丙氨酸氨基转移酶(ALT)、天冬酸氨基转移酶(AST)、血清白蛋白(Alb)、凝血酶原时间(PT)、肿瘤大小、血管侵犯、包膜及TNM分期、辅助治疗情况比较,差异无统计学意义(P>0.05)。研究组的60岁患者所占比例、中性粒细胞和淋巴细胞比值(NLR)<5患者所占比例、甲胎蛋白(AFP)<400 ng/dl患者所占比例、肿瘤分布两叶患者所占比例高于对照组,差异有统计学意义(P<0.05)。年龄、NLR、AFP、肿瘤分布、TNM分期、围术期输血、手术方式均为原发性单发肝癌手术切除后预后的影响因素。结论乙型肝炎相关性原发性肝癌的预后影响因素包括年龄、NLR、AFP、肿瘤分布、TNM分期、围术期输血、手术方式,实施抗病毒治疗有助于改善其预后。

Objective To investigate the prognostic factors of hepatitis B related primary liver cancer. Methods The clinical data of 100 patients with hepatitis B related primary liver cancer from March 2013 to March 2016 were analyzed retrospectively. All patients received surgical resection and antiviral treatment. They were divided into the control group（n=50, survival time： more than 3 years） and the study group（n=50, survival time： 3 years or less）, and the prognostic factors were analyzed. Results There was no significant difference in sex, ascites, ALT, AST, Alb, PT, tumor size, tumor size, vascular invasion, capsule and TNM staging, and adjuvant treatment in the two groups（P〉0.05）. The proportion of 60 year old patients, the proportion of NLR〈5 patients, the proportion of AFP400 ng/dl, the proportion of two leaves of the tumor in the study grou were higher than those in the control group, the difference was statistically significant（P〈0.05）. The age, NLR, AFP, and the tumor distribution Stage TNM, perioperative blood transfusion and surgical procedures were all prognostic factors for primary hepatocellular carcinoma after surgical resection. Conclusion The prognostic factors of hepatitis B related primary liver cancer include age, NLR, AFP, tumor distribution, TNM stage, perioperative blood transfusion, and surgical methods. Antiviral therapy can improve the prognosis.