HBV相关性肝细胞肝癌发生微血管侵犯的危险因素分析  

Analysis of Risk Factors of Microvascular Infiltration in Hepatocellular Carcinoma Caused by Hepatitis B Virus Infection

作　　者：李涛 李海明 王根旺[3] 刘迪[3] 周侃 于松宁[3] LI Tao;LI Haiming;WANG Genwang;LIU Di;ZHOU Kan;YU Songning(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China;Department of Hepatobiliary Surgery,the First People's Hospital of Yinchuan,Yinchuan 750001,China;Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,银川750004 [2]银川市第一人民医院肝胆外科,银川750001 [3]宁夏医科大学总医院肝胆外科,银川750004

出　　处：《宁夏医科大学学报》2021年第5期493-497,512,共6页Journal of Ningxia Medical University

摘　　要：目的探讨乙型肝炎病毒(HBV)相关性肝细胞肝癌(HCC)患者发生微血管侵犯(MVI)的危险因素。方法回顾性收集2015年1月至2019年12月于宁夏医科大学总医院肝胆外科行肝癌切除术患者的临床病理资料,根据患者术后病理检查结果是否合并MVI进行分组。将单因素分析有统计学意义的变量纳入多因素Logistic回归,筛选影响HBV相关性HCC发生MVI的独立危险因素。结果169例HCC患者中合并MVI患者76例。单因素分析显示,术前乙肝病毒e抗原(HBeAg)阳性、合并肝硬化、中性粒细胞绝对值(NEUT)、中性粒细胞绝对值/淋巴细胞绝对值(NLR)、血小板绝对值/淋巴细胞绝对值(PLR)、γ-谷氨酰转肽酶(GGT)、甲胎蛋白(AFP)、最大肿瘤直径、肿瘤细胞分化程度、侵及肝被膜以及伴发卫星灶两组比较差异均有统计学意义(P均<0.05)。Logistic回归分析显示,术前GGT、AFP升高以及合并肝硬化、侵及肝被膜、合并卫星灶是HBV相关性HCC患者发生MVI的独立危险因素(P均<0.05)。结论术前GGT、AFP升高以及合并肝硬化、侵及肝被膜、合并卫星灶与HBV相关性HCC患者发生MVI密切相关。Objective To explore the risk factors of microvascular invasion(MVI)in patients with HBV-related hepatocellular carcinoma(HCC).Methods The clinicopathological data of patients who underwent hepatectomy in the Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University from January 2015 to December 2019 were collected retrospectively.The patients were divided into groups according to the results of postoperative pathological examination combined with MVI.Multivariate Logistic regression analysis was performed on the statistically significant variables in the results of univariate analysis to screen the independent risk factors affecting the occurrence of MVI in HBV-related HCC.Results Among the 169 patients with HCC,76 patients were complicated with MVI.Univariate analysis showed that preoperative hepatitis B virus e antigen(HBeAg)positive,complicated with liver cirrhosis,neutrophil absolute value(NEUT),neutrophil absolute value/lymphocyte absolute value(NLR),platelet absolute value/lymphocyte absolute value(PLR),γ-glutamyl transpeptidase(GGT),alpha-fetoprotein(AFP),maximum tumor diameter,tumor cell differentiation,invasion of hepatic capsule and satellite focus were the related factors of MVI in HBV-related HCC(P all<0.05).Further logistic regression analysis showed that liver cirrhosis,invasion of hepatic capsule,satellite focus and the increase of GGT and AFP before operation were independent risk factors for MVI in patients with HBV-related HCC(P all<0.05).Conclusion Before operation,the increase of GGT and AFP,liver cirrhosis,invasion of hepatic capsule and satellite focus were closely related to the occurrence of MVI in patients with HBV-related HCC.

关 键 词：肝细胞肝癌 微血管浸犯 乙型病毒性肝炎 

分 类 号：R735.7[医药卫生—肿瘤]