术前血清直接胆红素与肝细胞癌的病理特征及预后的关系

Relationship between preoperative serum direct bilirubin and pathological features and prognosis of hepatocellular carcinoma

目的:探讨术前血清直接胆红素(DBIL)与肝细胞癌的病理特征及预后的关系。方法:回顾性分析2014年1月至2016年8月在广西医科大学附属肿瘤医院接受手术的186例肝癌患者的临床资料,其中DBIL阴性组135例,DBIL阳性组51例。分析术前血清DBIL水平与临床病理特征之间的关系。应用Kaplan-Meier法计算两组的总体生存率并用Log-rank检验分析两组的生存差异。采用Cox比例风险模型对肝癌患者预后的影响因素进行单因素和多因素分析。结果:血清DBIL水平与性别、民族、Child-Pugh分级、癌胚抗原(CEA)等临床病理学特征均有关(均P<0.05)。生存分析显示,DBIL阳性组较DBIL阴性组的总体生存率更低。单因素和多因素分析结果表明,术前血清DBIL水平是影响肝癌患者术后总体生存率的独立危险因素(P<0.05)。结论:术前血清DBIL升高是影响肝癌预后不良的独立危险因素。

Objective:To explore the relationship between preoperative serum direct bilirubin and the pathological features and prognosis of hepatocellular carcinoma.Methods:The clinical data of 186 patients with hepatocellular carcinoma who underwent surgery in our hospital from January 2014 to August 2016 were retrospectively analyzed.The patients were divided into DBIL-negative group(135 cases)and DBIL-positive group(51 cases).The relationship between preoperative serum DBIL level and clinicopathological features was analyzed.The overall survival of the two groups was evaluated by Kaplan-Meier method.The factors influencing the prognosis of patients was analyzed by univariate and multivariate analysis.Results:Serum DBIL level was associated with gender,ethnicity,Child-Pugh classification,and carcinoembryonic antigen(CEA)(P<0.05).The overall survival rate was lower in the DBIL-positive group than that in the DBIL-negative group.Univariate and multivariate analysis showed that preoperative serum DBIL level was an independent risk factor affecting overall survival of patients with hepatocellular carcinoma.Conclusion:Increase of preoperative serum DBIL level was an independent risk factor for the poor prognosis of hepatocellular carcinoma.