术前血清γ-谷氨酰转肽酶/血小板比值指数与乙肝病毒相关性肝细胞癌术后患者预后的关系  

The association between ratio index of gamma glutamyl transpeptidase/platelet and the prognosis of patients with hepatitis B virus related hepatocellular carcinoma before liver resection

作　　者：张宇[1] 吴丽君[2] 马良[1] 向邦德[1] 吴飞翔[1] 游雪梅[1] 黎乐群[1] ZHANG Yu;WU Li-jun;MA Liang;XIANG Bang-de;WU Fei-xiang;YOU Xue-mei;LI Le-qun(Department of Hepatobiliary Surgery, the Affiliated Tumor Hospital, Guangxi Medical University, Nanning 530021, China;Department of Hepatobiliary Surgery, the First Affiliated Hospital, Guangxi Medical University)

机构地区：[1]广西医科大学附属肿瘤医院肝胆外科,南宁530021 [2]广西医科大学第一附属医院肝胆外科

出　　处：《天津医药》2017年第5期489-492,共4页Tianjin Medical Journal

基　　金：国家科技重大专项项目(2012ZX10002010001009);国家自然科学基金资助项目(81260088)

摘　　要：目的探讨术前血清γ-谷氨酰转肽酶/血小板比值指数(GPRI)与乙肝病毒(HBV)相关性肝细胞癌(HCC)术后患者预后的关系。方法回顾性分析368例HBV相关性HCC患者的临床病理资料,将患者分为高GPRI组(GPRI≥0.38,184例)和低GPRI组(GPRI<0.38,184例)。比较2组患者的临床病理特点、无病生存率和总生存率,并利用Cox多因素分析确定影响HBV相关性HCC患者术后无病生存率和总生存率的危险因素。结果与低GPRI组相比,高GPRI组总胆红素和谷丙转氨酶水平更高、肿瘤侵犯大血管的比例更高、最大直径≥10 cm、肿瘤数目≥3个、中晚期HCC患者的比例更高(均P<0.05)。高GPRI组患者术后1、3、5年的无病生存率明显低于低GPRI组患者(50.8%、16.9%、5.7%vs.69.0%、33.3%、10.7%,P=0.001)。高GPRI组患者术后1、3、5年的总生存率也明显低于低GPRI组患者(75.0%、51.8%、36.0%vs.89.8%、72.8%、63.2%,P<0.05)。Cox多因素分析也证实GPRI≥0.38是影响HBV相关性HCC患者术后无病生存率和总生存率的独立危险因素。结论术前GPRI可以预测HBV相关性HCC患者术后的肿瘤复发和远期生存情况。Objective To explore the association between ratio index of gamma glutamyl transpeptidase/platelet(GPRI)and the prognosis of patients with hepatitis B virus(HBV)related hepatocellular carcinoma(HCC)before liverresection.Methods A total of368patients underwent liver resection for HBV-related HCC were retrospectively analyzedin this study.Patients were divided into high GPRI group(n=184,GPRI≥0.38)and low GPRI group(n=184,GPRI<0.38).Clinicopathologic characteristics including overall survival(OS)and disease-free survival(DFS)were compared between thetwogroups.IndependentriskfactorsinfluencingDFSandOSweredeterminedbyCoxmultivariateanalysis.Results Comparedto low GPRI group,there were higher levels of serum total bilirubin and alanine aminotransferase,higher proportions of tumordiameter larger than10cm,amount of tumou more than3,and patients with macrovascular invasion and intermediate oradvanced HCC in high GPRI group(all P<0.05).Values of DFS at1,3,and5years were significantly lower in high GPRIgroup(50.8%,16.9%and5.7%)than those in low GPRI group(69.0%,33.3%,10.7%;P=0.001).Values of OS at1,3,and5years were also significantly lower in high GPRI group(75.0%,51.8%and36.0%)than those in low GPRI group(89.8%,72.8%and63.2%;P<0.05).Cox multivariate analysis also demonstrated that GPRI≥0.38was an independent risk factorfor DFS and OS in patients with HBV-related HCC after liver resection.Conclusion Preoperative GPRI can predict tumorrecurrence and long-term survival in patients with HBV-related HCC after liver resection.

关 键 词：Γ-谷氨酰转肽酶 血小板 癌 肝细胞 乙型肝炎病毒 肝切除术 预后 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]