基于18F-FDGPET／CT显像结果分析肝细胞癌肝移植后肿瘤复发的危险因素  

Analysis of the risk factors of hepatocellular carcinoma recurrence after liver transplantation based on 18 F-FDG PET/C1

作　　者：许泽清[2] 张林启 何巧[1] 张祥松[1] 

机构地区：[1]中山大学附属第一医院,广州510000 [2]中山大学附属第五医院 [3]广州医科大学附属肿瘤医院

出　　处：《中华器官移植杂志》2014年第8期460-463,共4页Chinese Journal of Organ Transplantation

摘　　要：目的基于肝移植术前氟代脱氧葡萄糖-正电子发射型计算机断层显像（18F-FDGPET／CT）结果探讨影响肝细胞癌（HCC）肝移植术后复发的危险因素。方法选择2008年9月至2012年11月接受肝移植的54例HCC患者。单因素分析中，存活率的计算采用Kaplan-Meier方法，存活率的组间比较采用Logrank检验；应用ROC曲线探讨18F-FDGPET／CT显像的靶／本（T／B）值影响术后HCC复发的最佳临界值。采用Cox回归模型分析影响肿瘤复发的独立危险因素。结果54例受者随访期间共出现肿瘤复发26例（26／54，48．1％），全组受者术后0．5、1、2、3和4年的累积肿瘤无复发存活率分别为92．6％、66．71％、52．2％、49．1％和49．1％；单因素结果显示，影响HCC肝移植受者术后肿瘤复发的因素为PET显像（P=0．003）、肿瘤最大直径（P〈0．001）、肿瘤数目（P=0．001）、术前甲胎蛋白（AFP）水平（P〈0．001）、肿瘤分级（P=0．015）；ROC曲线分析结果显示，T／B值=1．69是影响HCC术后复发的最佳临界值；Cox回归多因素分析结果显示，T／B值（相对危险度=14．377，P〈0．001）和术前AFP水平（相对危险度=3．124，P=0．012）是影响HCC肝移植后肿瘤复发和转移的独立危险因素。结论18F-FDGPET／CT的T／B值〉1．69、术前AFP水平〉400μg／L等生物学因素是影响HCC肝移植后肿瘤复发的独立危险因素。Objective To analyze the risk factors of hepatocellular carcinoma （HCC） recurrence after liver transplantation based on 18 F-FDG PET/CT. Method We respectively analyzed 54 cases of HCC patients who accepted liver transplantation from 2008 September to 2012 November. The clinieopathological features of 54 patients were analyzed by univariate and multivariate analysis to determine the risk factors of HCC recurrence after liver transplantation. The ROC curve was drawn to determine the optimal cutoff value of T/B that affects HCC recurrence after liver transplantation. Result The total incidence of HCC recurrence was 48. 1% （26/54）the disease-free survival （DFS） rate of 0. 5 year, 1 year and 2 years after transplantation in 54 patients was 92. 6%, 66. 7%, 52. 2%, 49. 1 %and 49. 1% respectively. The univariate analysis results showed that there were 5 variables to affect HCC recurrence, namely PET imaging, tumor size, tumor number, preoperative AFP level, and tumor degree. On ROC curve analysis, the optimal cutoff value for T/B was 1.69. The multivariate analysis concluded that T/B, and preoperative AFP level were independent factors. Conclusion T/B 〉1.69 and preoperative AFP level〉400 μ%g/L are important biological factors of HCC recurrence after liver transplantation.

关 键 词：肝细胞癌 肝移植 18F-脱氧葡萄糖 正电子发射断层显像 体层摄影术 复发 

分 类 号：R735.7[医药卫生—肿瘤]