乙肝相关性巴塞罗那A期肝细胞癌术后早期复发转移的危险因素分析  

Risk factors for early recurrence and metastasis in BCLC A hepatocellular carcinoma patients after hepatectomy

作　　者：施显茂 陈洁[1] 麦荣云 龙中荣 刘劲梧 游雪梅[1] 吴飞翔[1] 黎乐群[1] Shi Xianmao;Chen Jie;Mai Rongyun;Long Zhongrong;Liu Jinwu;You Xuemei;Wu Feixiang;Li Lequn(Department of Hepatobiliary Surgery,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院肝胆外科,南宁530021

出　　处：《中华普通外科杂志》2019年第2期97-99,共3页Chinese Journal of General Surgery

基　　金：国家科技重大专项项目(2012ZX10002010001009);广西科学研究与技术开发项目(桂科攻14124003-4);广西青年自然科学基金资助项目(2016GXNSFBA380091);广西壮族自治区教育厅课题基金资助项目(2017KY0094).

摘　　要：目的探讨乙肝相关性巴塞罗那(BCLC)A期肝细胞癌术后早期复发转移的相关危险因素。方法回顾性分析2013年11月至2016年6月在我院行肝癌切除术的210例BCLC-A期患者的临床资料,采用多因素Logistic回归分析影响肝癌患者术后早期复发的相关因素,应用Kaplan-Meier作无瘤生存率分析,Log-Rank检验作相关临床病理因素分析。结果单因素分析结果示甲胎蛋白(AFP)、中性粒细胞/淋巴细胞比值(NLR)、乙肝病毒表面抗原(HBsAg)及术中输血与肝细胞癌术后早期复发相关(P<0.05),多因素分析表明AFP>400ng/ml是HCC术后早期复发的独立危险因素(P=0.008)。乙肝病毒DNA(HBVDNA)阳性可影响HCC术后无瘤生存率(P=0.030)。结论AFP是HCC术后早期复发的独立危险因素,HBVDNA阳性可降低HCC术后无瘤生存期。Objective To analyze the risk factors of postoperative recurrence and metastasis of of BCLC stage A (BCLC-A) hepatocellular carcinoma (HCC). Methods Data of 210 cases of liver resection for HCC were retrospectively analyzed from Nov 2013 to June 2016.Multivariate logistic regression analysis was used to analyze the risk factors for postoperative recurrence .The cumulative survival rates were calculated using the Kaplan-Meier method and the diffrences of the related factors between various groups were analyzed by Log-rank test. Results Univariate analysis showed that alpha-fetoprotein (AFP),neutrophil-lymphocyte ratio (NLR),hepatitis B virus surface antigen (HBsAg) positive and intraoperative transfusion were associated with early recurrence and metastasis after hepatectomy (P<0.05).Multivariate analysis showed that AFP>400 ng/ml is an independent risk factor for early postoperative recurrence and metastasis (P=0.008).HBV DNA positive can affect the disease-free survival rate after HCC resection (P=0.030). Conclusion AFP is an independent risk factor for early postoperative recurrence and metastasis.Preoperative HBV DNA positive significantly decreases the disease-free survival rate in HCC patients.

关 键 词：癌 肝细胞 肝切除术 肿瘤复发 局部 

分 类 号：R735.7[医药卫生—肿瘤]