ABO血型与HBV相关性肝细胞癌患者肝切除术后预后的关联研究

Association between ABO blood type and prognosis in patients with HBV-related hepatocellular carcinoma after hepatectomy

目的分析ABO血型与乙型肝炎病毒(HBV)相关性肝细胞癌(hepatocellular carcinoma,HCC)患者临床病理特征的相关性,并探讨其与HCC肝切除术后预后的关联。方法回顾性分析2014年1月1日至2017年12月31日于广西医科大学附属肿瘤医院首诊且行肝癌肝切除术并获随访的888例HBV相关性HCC患者的临床资料和预后状况。采用Cox比例风险回归模型分析ABO型与患者术后总生存率的关系。结果Kaplan-Meier生存分析结果显示,O血型、A血型、B血型和AB血型HCC患者的3年累计总生存率分别为68%、59%、64%、64%,差异无统计学意义(P>0.05)。多因素Cox比例风险回归分析显示,校正年龄、性别、吸烟史、饮酒史、肝硬化、血清AFP水平、BCLC分期和肿瘤包膜后,相比O血型患者,A血型患者的总生存率降低(HR=1.40,95%CI:1.07~1.83,P=0.015)。进一步分层分析显示,在男性、年龄≤55岁、有吸烟史、有饮酒史、AFP<400 ng/mL、肿瘤包膜完整的HCC患者中,A血型患者的总生存率均明显低于O血型患者(均P<0.05)。结论血型可能影响HCC患者肝切除术后的总生存率,A血型患者的总生存率较低。

Objective To analyze the correlation between ABO blood type and clinicopathological characteristics of HBV-associated HCC(HBV-HCC)patients,and to explore the influence of ABO blood type on the prognosis of HCC patients.Methods The clinical data and prognosis of 888 HBV-HCC patients,who were first diagnosed and then followed up at Guangxi Medical University Cancer Hospital and underwent liver cancer resection from January 2014 to December 2017,were retrospectively analyzed.The association between ABO blood type and the overall survival rate of HBV-HCC patients after surgery were analyzed by Cox proportional hazards regression.Results Kaplan-Meier survival analysis showed that the 3-year cumulative overall survival rates of patients with O,A,B and AB blood type were 68%,59%,64%and 64%,respectively,and no statistically significant difference was found among different patients(P>0.05).After adjusted for age,gender,smoking history,drinking history,liver cirrhosis,serum AFP level,BCLC stage,and tumor capsular,multivariable Cox regression analyses showed that,compared with patients with type O blood,patients with type A blood had a lower overall survival rate(HR=1.40,95%CI=1.07-1.83,P=0.015).Further stratified analyses indicated that,among the HCC patients who were male and younger than 55 years old smokers or drinkers or with AFP less than 400 ng/mL and complete tumor capsular(all P<0.05),those with type O blood had higher overall survival rate than those with type A blood.Conclusions Blood type may affect the overall survival rate of HCC patients after resection,and patients with type A blood have a lower overall survival rate.