肝细胞癌根治术后早期肺转移影响因素分析及预测的数学模型  

Risk factors and prediction equation linked to early pulmonary metastasis of hepatocellular carcino- ma after curative hepatic resection

作　　者：黄尧[1] 池闽辉[1] 曾永毅[1] 刘景丰[1] 曾金华[1] 吴燕斌[1] 罗顺峰[1] 黄爱民[2] 

机构地区：[1]福建医科大学附属第一医院肝病中心肝外科福建省肝病科学研究中心,福州350005 [2]福建医科大学病理学系

出　　处：《中华实验外科杂志》2012年第7期1383-1385,共3页Chinese Journal of Experimental Surgery

基　　金：福建省科技厅重大专项资助项目（2011Y0022）;福建省属高校科研项目基金资助项目（JK2011021）;福建省自然科学基金资助项目（2011J01162）

摘　　要：目的探讨肝细胞癌（HCC）根治术后早期肺转移影响因素及预测的数学模型。方法对400例根治性切除术的肝细胞癌患者的性别、年龄、肿瘤大小、术前甲胎蛋白（AFP）、合并乙型肝炎病毒（HBV）感染、手术前肿瘤数目、合并肝硬化、肿瘤包膜、镜下脉管癌栓、病理分化分级进行单因素、多因素分析及数学建模。结果术后1年肺转移发生率为8．0％（32／400）。有无肺转移组在肿瘤大小、术前AFP、镜下脉管癌栓方面比较差异有统计学意义（P〈0．05）。术后1年内肺转移的独立判断因素为肿瘤大小、镜下脉管癌栓，预测概率为1．14％～27．23％。结论肿瘤大小、镜下脉管癌栓为术后早期肺转移的独立判断因素。Objective To investigate the risk factors and the prediction equation linked to early pul- monary metastasis of hepatocellular carcinoma after curative hepatic resection. Methods A series of 400 hepatocelluar carcinoma patients who received radical operation were investigated retrospectively. Single factor analysis and multivariate logistic regression analysis were performed to analyze the relevant clinical and pathological indicators, including sex, ages, tumor diameter, the level of alpha fetal protein （AFP）, hepatitis B virus （HBV） infection, number of tumors, hepatic cirrhosis, tumor envelop, tumor thrombus, and pathological classification, etc. Results The ratio of pulmonary metastasis one year postoperation was 8. 0% （32/400）. The indicators, including the tumor diameter, the level of AFP, and tumor thrombus were different significantly between pulmonary metastasis group and ndn-pulmonary metastasis group. The multivariate logistic regression analysis indicated that the independent prognostic factors of pulmonary me- tastasis of hepatocelluar carcinoma one year after curative hepatic resection were the tumor diameter and tumor thrombus. The prediction equation indicated that the predicted ratio of pulmonary metastasis was from 1.14% to 27.23%. Conclusion The independent prognostic factors of pulmonary metastasis of hepatocel- luar carcinoma one year after curative hepatic resection were the tumor diameter and tumor thrombus.

关 键 词：癌 肝细胞 肺转移 预测 

分 类 号：R735.7[医药卫生—肿瘤]