年龄对肝癌合并糖尿病患者预后的影响:基于倾向值匹配的分析  

Effect of age on prognosis of hepatocellular carcinoma patients with diabetes mellitus:apropensity-score matching analysis

作　　者：罗翠松[1,2] 汪珍光[3] 林云[1] 邹卫兵[4] 曾志峰[1] 蒋星星[1] 周伟平[3] 时军[2] 

机构地区：[1]南昌大学附属新余医院肝胆胰外科,新余338000 [2]南昌大学第一附属医院肝胆胰外科,南昌330000 [3]第二军医大学东方肝胆外科医院肝外三科,上海200438 [4]南昌大学附属新余医院肿瘤中心,新余338000

出　　处：《第二军医大学学报》2016年第9期1171-1175,共5页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81450045);江西省卫生和计划生育委员会科研项目(20167194)~~

摘　　要：目的 探讨年龄对乙型肝炎病毒相关肝癌合并糖尿病患者根治性切除预后的影响。方法 回顾性分析250例行肝癌根治性切除的乙型肝炎病毒相关肝癌合并糖尿病患者的临床资料。患者年龄30~80岁,其中≥60岁（老年组）58例,〈60岁（非老年组）192例。利用倾向值匹配（propensity score matching,PSM）的方法均衡组间协变量后,比较两组患者的总体生存率,并用Cox回归分析影响肝癌预后的风险因素。结果 经PSM法匹配后,老年组（53例）与非老年组（85例）患者的1、3、5年的总体生存率分别为94.5%和90.6%、73.2%和61.2%、52.9%和43.7%,组间差异无统计学意义（P=0.15）。Cox回归多因素分析显示年龄不是影响乙型肝炎病毒相关肝癌合并糖尿病患者预后的独立危险因素。结论 高龄并未降低乙型肝炎病毒相关肝癌合并糖尿病患者的术后累积生存率,老年患者可获得与年轻患者类似的生存率。Objective To explore the effect of age on prognosis of patients with hepatitis B virus（HBV）-related hepatocellular carcinoma（HCC）complicated with diabetes mellitus（DM）after radical resection.Methods The clinical data of250 patients with HBV-related HCC complicated with DM who received radical resection were collected from the First Affiliated Hospital of Nanchang University and the Eastern Hepatobiliary Surgery Hospital and were retrospectively analyzed.The patients aged 30-80 years old and were divided into the elder group（≥60years,n=58）and the non-elder group（60years,n=192）.Propensity score matching（PSM）method was used for covariate balance and the overall survival（OS）rates were compared between the two groups.Cox regression was used to analyze the risk factors influencing the prognosis of HCC.Results In the PSM cohort（n=53in elder group,n=85in non-elder group）,the 1-,3-,5-year OS rates were not significantly different between the two groups（P=0.15）.The results of Cox multivariate regression analysis revealed that age was not significantly associated with OS of patients with HBV-related HCC complicated with DM.Conclusion Elder age seems not to decrease the OS of patients with HBV-related HCC complicated with DM after radical resection;elder patients can obtain similar survival as the non-elder ones.

关 键 词：肝肿瘤 肝细胞癌 糖尿病 存活率分析 倾向性得分匹配法 年龄 

分 类 号：R735.7[医药卫生—肿瘤] R587.1[医药卫生—临床医学]