血清CA19-9评估原发性肝细胞癌微血管侵犯

The clinical study of serum CA19-9 in evaluating microvascular invasion in primary hepatocellular carcinoma

目的探讨患者血清CA19-9水平与原发性肝细胞癌微血管侵犯(MVI)的关系。方法收集2009年4月~2013年12月在南充市中心医院进行完整根治切除的原发性肝细胞癌患者271例。对年龄、性别、Child-Pugh分级、血清AFP水平、CEA水平、CA19-9水平、肿瘤数目及Ishak分级分别进行连续变量和二分变量分析,采用Logistic回归分析和Pearson χ^(2)检验,对临床病理参数和微血管侵犯之间的关联进行分析,以确定与微血管侵犯显著相关的独立预测因素。结果单因素分析显示在预测肝癌微血管侵犯的变量中,性别、肿瘤大小、肿瘤数目、AFP、CA19-9与肝癌微血管侵犯显著相关(P<0.05)。多因素分析显示肿瘤数目,肿瘤大小和CA19-9是独立预测肝癌微血管侵犯的术前危险因素(P<0.05)。结论血清CA19-9是术前预测原发性肝细胞癌微血管侵犯的独立危险因素。

Objective To investigate the relationship between serum CA19-9 level and microvascular invasion(MVI)of primary hepatocellular carcinoma.Methods 271 patients with primary hepatocellular carcinoma who underwent complete radical resection in Nanchong Central Hospital from April 2009 to December 2013 were collected.Age,sex,child Pugh grade,serum AFP level,CEA level,CA19-9 level,tumor number and Ishak grade were analyzed by continuous variable and binary variable analysis respectively.The correlation between clinicopathological parameters and microvascular invasion was analyzed by logistic regression analysis and Pearson's substance 2 test to identify independent predictors significantly associated with microvascular invasion.Results Univariate analysis showed that among the variables predicting microvascular invasion of liver cancer,gender,tumor size,tumor number,AFP and CA19-9 were significantly correlated with microvascular invasion of liver cancer(P<0.05).Multivariate analysis showed that tumor number,tumor size and CA19-9 were independent preoperative risk factors for microvascular invasion of hepatocellular carcinoma(P<0.05).Conclusion Serum CA19-9 is an independent risk factor for preoperative prediction of microvascular invasion of primary hepatocellular carcinoma.