aMAP风险评分对小肝癌微波消融术后早期复发的预测价值  

Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation

作　　者：董书语 邓淑云 樊蓉[1] 陈锦章[1] 程笑[1] 郝新 戴文聪[1] Dong Shuyu;Deng Shuyun;Fan Rong;Chen Jinzhang;Cheng Xiao;Hao Xin;Dai Wencong(Department of Infectious Diseases and Hepatology Unit,Nanfang Hospital,Southern Medical University,State Key Laboratory of Organ Failure Research,Guangdong Provincial Key Laboratory of Viral Hepatitis Research,Guangdong Provincial Institute of Liver Diseases,Guangzhou 510515,China;First Clinical Medical College,Southern Medical University,Guangzhou,Guangzhou,510515,China)

机构地区：[1]南方医科大学南方医院肝病中心暨感染内科、器官衰竭国家重点实验室、广东省病毒性肝炎研究重点实验室,广东省肝脏疾病研究所,广州510515 [2]南方医科大学第一临床医学院,广州510515

出　　处：《中华内科杂志》2023年第11期1329-1334,共6页Chinese Journal of Internal Medicine

摘　　要：目的探究aMAP风险评分对小肝癌患者微波消融术后早期(1年内)复发的预测价值。方法回顾性队列研究。收集2016年7月至2021年7月在南方医科大学南方医院肝病中心进行微波消融术治疗的142例小肝癌患者资料。男性121例,女性21例;年龄≤60岁110例,>60岁32例。术后通过肝脏CT或磁共振成像(MRI)随访判断肿瘤残留及复发情况,观测指标主要包括患者一般资料、影像学资料等。通过X-tile工具将患者划分为高aMAP评分组和低aMAP评分组。采用多因素Cox分析早期复发的独立危险因素。结果多因素Cox回归结果显示aMAP高评分、肿瘤最大径>20 mm、高甲胎蛋白水平为早期复发的独立危险因素(均P<0.05)。Kaplan-Meier生存曲线显示低aMAP评分组患者中位无复发生存期为25.5个月,高aMAP评分组为6.1个月,差异有统计学意义(P=0.001)。结论aMAP评分在预测小肝癌消融术后早期复发中有一定价值,针对术前高aMAP评分的患者应行术后严密随访。Objective To explore the value of the aMAP risk score(age,male,albumin-bilirubin,and platelets)to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma.Methods This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital,Southern Medical University from July 2016 to July 2021.The cohort enrolled 121 male and 21 female patients,including 110 patients that were<60 years old.All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging.The observation indices mainly included general data and imaging data of patients.Using the X-tile tools,patients were divided into two groups:a high aMAP score group and a low aMAP score group.Multivariate Cox regression analysis was conducted for comparison of independent risk factors.Results Multivariate Cox regression showed that high aMAP score,maximum tumor diameter>20 mm,and high AFP were the independent risk factors of early recurrence(all P<0.05).Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group(P=0.001).Conclusions The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation.Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..

关 键 词：aMAP评分 肿瘤复发 局部 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]