基于SEER数据库的肝细胞肝癌脑转移危险因素分析

Analysis of Risk Factors for Brain Metastasis of Hepatocellular Carcinoma Based on SEER Database

目的:应用SEER数据库探索肝细胞(hepatocellular carcinoma,HCC)肝癌脑转移相关危险因素,以指导临床早期筛查。方法:获取SEER数据库2004-2016年符合入排标准的36091例患者的临床数据,单因素分析及多因素Logistics回归分析发生脑转移的危险因素。结果:36091例患者脑转移108例,发生率为0.33%,伴脑转移患者中位生存期7个月,无脑转移患者中位生存期12个月。单因素分析显示病理低分化及未分化、存在淋巴结转移、无手术切除史、无化疗史及有放疗治疗史患者更容易存在脑转移病灶(P<0.05)。多因素分析提示无外科手术史、无化疗史及有放疗治疗史是发生脑转移的独立危险因素(P<0.001)。结论:无外科手术、无化疗史及有放疗治疗史是肝细胞肝癌发生脑转移的独立危险因素。

Objective:To explore the risk factors of hepatocellular carcinoma brain metastasis based on SEER database,to guide early clinical screening.Method:A total of 36091 patients who met inclusion and exclusion criteria were extracted from 2004 to 2016 of the SEER database.The risk factors of brain metastasis were analyzed by univariate analyses and multivariate logistics regression analysis.Result:Among 36091 HCC patients,there were 108 patients occurred brain metastasis and the rate was 0.33%.The median survival of patients with or without brain metastases were 7 and 12 months,respectively.Univariate analyses showed that patients with pathological differentiation and undifferentiated,lymph node metastasis,no history of surgical resection,no history of chemotherapy and radiotherapy were correlated with the occurrence of brain metastasis(P<0.05).The results of multivariate analyses showed that the patients with no surgery resection,no chemotherapy and those with history of radiotherapy were independent risk factors for brain metastasis(P<0.001).Conclusion:Treatment without surgery,no chemotherapy and the history of radiotherapy were independent risk factors for brain metastases of hepatocellular carcinoma.