肝细胞癌患者的基本特征及其生存分析  

Basic characteristics and survival analysis of patients with hepatocellular carcinoma

作　　者：管晨滔 赵宏[2] 李新庆[1] 曲宸绪[1] 蔡建强[2] 魏文强[1] 乔友林[1] Guan Chentao Zhao Hong Li Xinqing Qu Chenxu Cai Jianqiang Wei Wenqiang Qiao Youlin(Department of Epidemiology, Cancer Hospital, Peking Union Medical College ＆ Chinese Academy of Medical Sciences, Beijing 100021, China Department of Hepatobiliary Surgery, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China)

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院流行病学室,100021 [2]北京协和医学院中国医学科学院肿瘤医院肝胆外科,100021

出　　处：《中华肿瘤杂志》2017年第3期231-235,共5页Chinese Journal of Oncology

摘　　要：目的分析肝细胞癌患者的基本特征，探讨影响肝细胞癌患者预后的主要因素。方法单纯随机抽样抽取800例住院就诊的肝细胞癌患者，获取相关临床和随访资料。采用单变量方差分析、Kaplan－Meier法和Cox回归分析对患者的诊断年龄、生存时间等进行分析。结果800例肝细胞癌患者的平均诊断年龄为55.04岁，男女之比为4.48∶1。800例肝细胞癌患者的乙肝病毒（HBV）感染率为78.6%（629/800），丙肝病毒（HCV）感染率为5.8%（46/800），吸烟率为41.0%（328/800），酗酒率为38.5%（308/800）。259例（32.4%）患者采用根治性疗法，主要治疗手段为肝切除；541例（67.6%）的患者采用非根治性疗法，主要治疗手段为肝动脉化疗栓塞。肝细胞癌患者的1年、3年和5年生存率分别为73.2%、53.7%和42.4%。影响肝细胞癌患者预后的危险因素包括酗酒和治疗方法，其中酗酒的相对危险度为1.326（95%CI为1.058-1.661），治疗方法的相对危险度为3.301（95%CI为2.483-4.387）。结论中国肝细胞癌临床就诊病例中男性居多，诊断年龄低，采用非根治性疗法的患者多。HBV感染和酗酒等暴露率明显高于普通人群，影响肝细胞癌患者生存的主要危险因素是酗酒和治疗方法，HBV感染和酗酒有协同作用，对肝细胞癌患者的生存产生影响。Objective To analyze the basic characteristics of patients with hepatocellular carcinoma （HCC） , and further explore the major factors affecting the prognosis of HCC patients. Methods A total of 800 HCC patients were randomly selected from the Cancer Hospital, Chinese Academy of Medical Sciences. Their clinical and follow-up information was obtained from medical record. Univariate analysis of variance, Kaplan-Meier method and Cox regression analysis were used to analyze the patients＇ age at diagnosis and survival time, etc. Results The average age of diagnosis was 55.04 years among all the 800 HCC patients, and the sex ratio of male to female was 4.48. The infection rates of HBV and HCV were 78.6% （629/800） and 5.8% （ 46/800）, respectively. The smoking rate was 41.0% （328/800） and the alcohol consumption rate was 38.5% （328/800）. 259 （32.4%） patients underwent radical treatments with liver resection as major therapy, and 541 （67.6%） patients adopted non-radical treatments with transcatheter arterial chemoembolization （TACE） as major therapy. The 1-, 3- and 5-year survival rates of the HCC patients were 73.2%, 53.7% and 42.4%, respectively. The risk factors for prognosis included alcohol abuse and treatment methods. The HR of alcohol abuse was 1.326 （95%CI：1.058 to 1.661 ） and HR of treatment methods was 3.301 （95% CI： 2.483 to 4.387）. Conclusions Men account for the majority of HCC patients, and most patients have a lower age at diagnosis and adopt non-radical treatments. The exposure rates of HBV infection and alcohol abuse of HCC patients are significantly higher than those of general population. The major risk factors affecting prognosis and survival are treatments and alcohol abuse. Alcohol abuse and HBV may have synergistic effects on the survival of HCC patients.

关 键 词：癌 肝细胞 酒精 基本特征 预后 

分 类 号：R735.7[医药卫生—肿瘤]