乙肝相关性肝癌患者根治性切除术预后影响因素Cox回归分析  

Influencing factors of prognosis among HBV-related HCC patients with radical resection:a Cox regression analysis

作　　者：张浩洋[1] 曹毅[2] 徐玥 杨远航[1] 刘昊[4] 吕立志[2] 

机构地区：[1]中山大学公共卫生学院,广东广州510000 [2]南京军区福州总医院肝胆外科 [3]中山大学中山医学院 [4]深圳市宝安区疾病预防控制中心

出　　处：《中国公共卫生》2017年第11期1646-1649,共4页Chinese Journal of Public Health

基　　金：福建省自然科学基金重点项目(2014Y0034);福州总医院创新团队专项资助项目(cxtd05)

摘　　要：目的了解乙肝相关性肝癌患者行根治性切除术后预后的影响因素,为提高肝癌术后患者的生存质量提供参考依据。方法对2003年12月—2012年12月在南京军区福州总医院行根治性肝切除术的426例乙肝相关性肝癌患者每2~4个月进行1次电话随访,了解其预后情况;应用R 3.1.2统计软件采用单因素和多因素Cox回归分析方法分析乙肝相关性肝癌患者行根治性切除术后预后的影响因素。结果随访的426例乙肝相关性肝癌患者术后的平均生存时间为(42.06±26.7)个月,其中第1、2、3、4、5年的生存率分别为86.15%、73.71%、66.67%、61.27%、58.92%;多因素Cox回归分析结果显示,肿瘤有血液转移、肝功能Child-Pugh分级B级、甲胎蛋白(AFP)含量>400 ng/m L、Topo IIα高表达和饮酒是影响行根治性切除术后乙肝相关性肝癌患者预后的危险因素;有肿瘤包膜和Edmonson病理分级I级是影响行根治性切除术后乙肝相关性肝癌患者预后的保护因素。结论肿瘤包膜情况、血液转移情况、Edmonson病理分级、肝功能Child-Pugh分级、AFP含量、Topo IIα表达和饮酒情况是影响行根治性切除术后乙肝相关性肝癌患者预后的主要因素。Objective To explore influencing factors of prognosis for hepatitis B virus（HBV）-related hepatocellular carcinoma（HCC） patients after radical resection and to provide references for improving life quality of the patients.Methods We enrolled 426 HCC patients with radical resection from December 2003 through 2012 and conducted telephone follow-up every 2-4 months to collect relevant information. R 3. 1. 2 was used in univariate and multivariate Cox regression to analyze the influencing factors of survival among the patients. Results The mean survival time of the patient was 42. 06 ± 26. 75 months and the 1-,2-,3-,4-,and 5-year survival rate were 86. 15%,73. 71%,66. 67%,61. 27%,and 58. 92% among the patients,respectively. Multivariate Cox regression analysis showed that the risk factors of the survival of the patients included vascular invasion,with a B Child-Pugh grade,α-fetoprotein（AFP） 400 ng/mL,high expression of topoisomerase IIα（TopoIIα）,and alcohol consumption,while the protective factors included tumor encapsulation and Edmonson grade I. Conclusion Vascular invasion,Child-Pugh grade,AFP,TopoIIα expression,alcohol consumption,tumor encapsulation,Edmonson grade could affect the prognosis of HBV-related HCC patients after radical resection.

关 键 词：乙肝相关性肝癌患者 根治性切除术 预后 影响因素 COX回归分析 

分 类 号：R735.7[医药卫生—肿瘤]