肝泡型包虫病远处转移的危险因素分析

Analysis of the risk factors for metastasis of hepatic alveolar echinococcosis

目的探讨影响肝泡型包虫病(AE)远处转移的相关危险因素。方法回顾性分析2016年1月至2022年1月新疆医科大学附属中医医院和新疆医科大学第一附属医院收治的138例肝AE患者的临床资料,其中男性79例,女性59例,年龄(39.6±11.7)岁。根据AE有无远处转移病灶分为两组:转移组(n=58)和非转移组(n=80)。收集患者的病灶位置、病灶大小、白蛋白、嗜酸性粒细胞百分比、囊液抗原(EgCF)等临床资料。多因素logistic回归分析远处转移的危险因素。结果转移组和非转移组患者的性别、民族、邻近器官累及情况、EgCF、白蛋白、病灶长径、病程、嗜酸性粒细胞百分比间比较,差异均具有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,少数民族(OR=5.674,95%CI:1.769~18.204,P=0.004)、有邻近器官累及(OR=3.821,95%CI:1.367~10.680,P=0.011)、EgCF阳性(OR=3.460,95%CI:1.093~10.951,P=0.035)、病灶长径大(OR=1.116,95%CI:1.012~1.230,P=0.027)、病程长(OR=1.009,95%CI:1.001~1.018,P=0.036)、嗜酸性粒细胞低(OR=0.799,95%CI:0.701~0.911,P=0.001)的肝AE患者,发生远处转移的风险高。结论少数民族、有邻近器官累及、EgCF阳性、病灶长径大、病程长、嗜酸性粒细胞低是AE患者发生远处转移的独立危险因素。

ObjectiveTo analyze the risk factors that affects the metastasis of hepatic alveolar echinococcosis(HAE).MethodsClinical data of 138 patients with HAE admitted to the Xinjiang Medical University Affiliated Traditional Chinese Medicine Hospital and the First Affiliated Hospital of Xinjiang Medical University between January 2016 and January 2022 were retrospectively analyzed,including 79 males and 59 females,aged(39.6±11.7)years old.Patients were divided into two groups according to the presence of metastatic lesions of HAE:the metastasis group(n=58)and non-metastasis group(n=80).Clinicopathological data including the lesion location,lesion size,serum albumin level,eosinophil count,and echinococcus granulosus cystic fluid(EgCF)were collected.Multivariate logistic regression analysis was utilized to identify the risk factors of metastasis.ResultsStatistically significant differences were observed between the metastasis group and non-metastasis group in terms of gender,ethnicity,involvement of adjacent organs,EgCF status,serum albumin level,maximum lesion diameter,disease duration,and eosinophil count(all P<0.05).The results of multivariate logistic regression analysis showed that patients from the minority ethnic groups(OR=5.674,95%CI:1.769-18.204,P=0.004),with involvement of adjacent organs(OR=3.821,95%CI:1.367-10.680,P=0.011),positive EgCF(OR=3.460,95%CI:1.093-10.951,P=0.035),larger maximum lesion diameters(OR=1.116,95%CI:1.012-1.230,P=0.027),longer disease durations(OR=1.009,95%CI:1.001-1.018,P=0.036),and lower eosinophil count(OR=0.799,95%CI:0.701-0.911,P=0.001)were at higher risk of developing distant metastases.ConclusionEthnic minorities,involvement of adjacent organs,positive EgCF,large lesion length,long disease duration,and low eosinophil count are independent risk factors for distant metastasis in patients with HAE.