肝纤维化对射频消融治疗单发肝细胞癌患者长期预后的影响

Impacts of hepatic fibrosis on long-term prognosis of solitary hepatocellular carcinoma patients after radiofrequency ablation

目的观察肝纤维化程度对射频消融治疗后单发肝细胞癌(HCC)患者长期预后的影响。方法回顾性分析363例美国国立癌症研究所监测、流行病学和结果数据库(SEER)中经射频消融治疗单发HCC患者,根据肝纤维化评分(FS)将其分为0~4分组(FS 0~4分组)和5~6分组(FS 5~6分组)。采用Kaplan-Meier法构建生存曲线,以COX比例风险模型分析影响预后的因素。结果与FS 0~4分组比较,FS 5~6分组患者中位病因特异性生存期(CSS)下降(33个月vs 22个月,P<0.001)。FS 5~6分(P<0.001)、伴血管侵犯(P=0.041)、AFP升高(P=0.042)及肿瘤长径>3 cm(P=0.026)是CSS下降的独立危险因素。结论肝纤维化是影响射频消融治疗后单发HCC患者长期预后的独立危险因素。

Objective To observe the impacts of degree of hepatic fibrosis on long-term prognosis of solitary hepatocellular carcinoma(HCC)patients after radiofrequency ablation.Methods Data of 363 solitary HCC patients underwent radiofrequency ablation drawn from surveillance,epidemiology and end results database(SEER)from the US National Cancer Institute were retrospectively analyzed.The patients were divided into fibrosis score(FS)0-4 group(FS 0-4)and FS 5-6 group(FS 5-6).Survival curves were estimated using Kaplan-Meier method.COX proportional hazards model was used to evaluate the predictors of prognosis.Results The median cause specific survival(CSS)in FS 5-6 group was lower than that in FS 0-4 group(22 months vs 33 months,P<0.001).FS 5-6(P<0.001),tumor vascular invasion(P=0.041),elevated AFP(P=0.042)and the largest tumor diameter>3 cm(P=0.026)were independent risk factors for reduced CSS.Conclusion Hepatic fibrosis was an independent risk factor affecting long-term prognosis of solitary HCC patients who underwent radiofrequency ablation.