首诊乙肝相关原发性肝癌肝外转移危险因素分析

Risk factors for extrahepatic metastasis of hepatitis B-related hepatocellular carcinoma

目的探讨首诊时影响乙肝相关原发性肝癌肝外转移的危险因素。方法收集2016年1月至2017年10月资料完整的乙肝相关肝癌患者178例。根据有无肝外转移分为肝外转移组和无肝外转移组,比较两组患者首诊时的临床资料,并采用logistic回归分析乙肝相关原发性肝癌肝外转移的危险因素。结果178例患者中无肝外转移组147例,肝外转移组31例。肝外转移组与无肝外转移组患者的肿瘤大小、肿瘤个数、血管侵犯、肝功能Child-Pugh分级、甲胎蛋白比较差异均有统计学意义(均P<0.05)。多因素分析显示,肿瘤大小(OR=5.521,95%CI:1.410~21.613,P=0.014)、肿瘤个数(OR=1.882,95%CI:1.049~3.379,P=0.034)为乙肝相关原发性肝癌肝外转移的危险因素。结论乙肝相关原发性肝癌肝外转移与血管侵犯、Child-Pugh分级、肿瘤个数、肿瘤大小、甲胎蛋白有相关性,肿瘤大小及肿瘤个数为其独立危险因素,有助于首诊时对是否已发生转移作出判断。

Objective To investigate the risk factors of extrahepatic metastasis of hepatitis B-related hepatocellular carcinoma.Methods A retrospective analysis was conducted among patients with hepatitis B-related hepatocellular carcinoma who were diagnosed in Xixi Hospital from January 2016 to October 2017.The risk factors were analyzed byχ2 test,t test and logistic regression.Results A total of 178 patients with hepatitis B-related hepatocellular carcinoma were enrolled.There were 147 cases without extrahepatic metastasis and 31 cases with extrahepatic metastasis.Extrahepatic metastasis was associated with vascular invasion,Child-Pugh classification,number of tumors,size of tumors andα-fetoprotein level.Multivariate analysis showed that tumor size(P=0.014,95%CI:1.410~21.613,OR=5.521)and number of tumors(P=0.034,95%CI:1.049~3.379,OR=1.882)were independent risk factors for extrahepatic metastasis of hepatitis B-related hepatocellular carcinoma.Conclusion Extrahepatic metastasis of hepatitis B-related hepatocellular carcinoma is correlated with vascular invasion,Child-Pugh classification,number of tumors,size of tumors and alpha-fetoprotein.The size of tumors and number of tumors are independent risk factors.