新疆维吾尔族非乙非丙型及病毒相关性肝癌的临床特征及预后  

Comparison of clinical characteristics of non-B non-C hepatocellular carcinoma and hepatitis virusrelated hepatocdlular carcinoma and prognosis in Uighur patients

作　　者：张瑞丽[1] 周莎莎[1] 肖蕾[1] 张华[1] 艾斯克尔·吐拉洪[1] 张月芬[1] 温浩[1] 包永星[1] 

机构地区：[1]新疆医科大学第一附属医院肿瘤中心,乌鲁木齐830054

出　　处：《中华肿瘤杂志》2015年第7期540-544,共5页Chinese Journal of Oncology

基　　金：新疆维吾尔自治区自然科学基金资助项目（2014211C075）

摘　　要：目的探讨新疆维吾尔族肝细胞癌（HCC）患者的临床特征和预后。方法回顾性分析301例维吾尔族HCC患者的临床资料，分为非乙型非丙型肝癌组（NBC—HCC组）和病毒相关肝癌组（viral—HCC组）。采用Kaplan-Meier法计算生存率，采用Logrank检验对影响患者预后的因素进行单因素分析，采用Cox多因素对影响患者预后的因素进行多因素分析。结果NBC—HCC组患者的性别、城乡地区、糖尿病史、体质指数、肝硬化史、临床分期、Child-pugh分级、总胆红素和甲胎蛋白水平与viral—HCC组比较，差异均有统计学意义（均P〈0．05）。全组HCC患者的1、2、3、5年生存率分别为35．6％、20．3％、12．6％和4．5％；NBC—HCC组患者的1、2、3、5年生存率分别为32．2％、18．5％、14．7％和5．2％，viral-HCC组患者的1、2、3、5年生存率分别为38．0％、21．1％、13．5％和4．1％，差异无统计学意义（P=0．124）。多因素分析结果显示，年龄、临床分期、门静脉癌栓（PVTT）、Child—push分级、肝动脉化疗栓塞（TACE）联合放疗或射频消融（RFA）均为影响HCC患者预后的独立因素（均P〈0．05）。结论NBC-HCC组和viral—HCC组肝癌患者的临床特征不尽相同，具有一定的区域特点。年龄、临床分期、PVTT、Child-pugh分级、TACE联合放疗或RFA为影响HCC患者预后的独立因素。Objective This study was aimed to understand the clinical characteristics and prognosis in Uighur patients with Non-B Non-C hepatocellular carcinoma （HCC） and virus-related HCC. Methods We retrospectively analyzed the clinical data of 301 Uighur HCC patients, among them, there were 145 NBC- HCC cases and 156 virus-related HCC cases. The overall survival rates of the patients were analyzed by Kaplan-Meier method, and the factors that may influence the prognosis and survival of NBC-HCC patients were analyzed using univariate （Log rank test ） and multivariate Cox proportional hazard model. Results The differences of the gender, living region, history of diabetes, body mass index （BMI） , history of cirrhosis, TNM stage, Child-Pugh scores, total bilirubin, and AFP level between the NBC-HCC group and viral-HCC group were statistically significant （P〈0.05 for all）. The 1-,2-, 3- and 5-year survival rates were 35.6%, 20.3%, 12.6%, and 4.5%, respectively, for all the 301 patients, and no significant difference between these two groups in terms of OS （P 〉 0. 05 ）. Multivariate analysis by Cox model showed that age, TNM staging, PVTT, Child-Pugh scores, TACE combined with radiotherapy or RFA were significant independent prognostic factors （all P〈0.05）. Conclusions The clinical characteristics in Uighur patients with non-B non-C HCC and hepatitis virus-related HCC are not all the same and HCC in Xinjiang region has certain regional characteristics and features. Age, TNM stages, portal vein tumor thrombus, Child-Pugh scores, and TACE combined with radiotherapy or RFA are significant independent prognostic factors.

关 键 词：肝肿瘤 肝炎 病毒性 人 少数民族 病理学 临床 预后 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]