乙型肝炎相关肝癌预后相关组织病理特征与血清标志物相关性分析  

Correlation analysis of prognostic histopathological features and serum biomarkers in hepatocellular carcinoma with hepatitis B background

作　　者：李长凯 张昊[2] 董伟 何成建 黄剑 张小锋 杨业发 Li Changkai;Zhang Hao;Dong Wei;He Chengjian;Huang Jian;Zhang Xiaofeng;Yang Yefa(Department of Interventional Radiology,Third Hospital Affiliated to Naval Medical University,Shanghai 200438,China;Department of Interventional Therapy,Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]海军军医大学第三附属医院放射介入科,上海200438 [2]苏州大学附属第二医院介入治疗科,苏州215004

出　　处：《中华转移性肿瘤杂志》2024年第6期553-560,共8页Chinese Journal of Metastatic Cancer

摘　　要：目的探讨能准确反映慢性乙型肝炎相关肝细胞癌(HCC)炎症程度的血清学指标。方法回顾性分析2011—2018年间接受肿瘤切除手术并确诊为HCC的260例患者的临床病理特征与血清学指标。以血清乙型肝炎病毒DNA(HBV-DNA)载量等作为血清学指标,汇管区炎细胞数(NICP)作为炎症程度指标,局部加权散点图平滑(LOWESS)分析显示其重复性,并通过多因素Cox回归分析和列线图检测其预后价值。结果血清HBV-DNA载量与NICP高度相关(P<0.001),LOWESS分析显示结果重复性好,队列的多变量分析显示NICP、HBV-DNA、TNM分期和血清谷丙转氨酶是总生存的独立影响因素。基于校正曲线的生存概率显示,列线图预测结果与实际观测结果吻合较好。结论血清HBV-DNA载量可以准确反映HCC的炎症程度,并对于准确预测HCC患者预后具有重要价值。Objective To explore serological indicators that accurately reflect the inflammatory degree of hepatocellular carcinoma(HCC)associated with chronic hepatitis B.Methods The clinical pathological features and serological indicators of 260 patients who underwent surgical resection and were diagnosed HCC from 2011 to 2018 were analyzed retrospectively.Serum hepatitis B virus DNA(HBV-DNA)load was used as the serological indicator,and the number of inflammatory cells in the portal area(NICP)was used as the indicator of inflammatory degree.Locally weighted scatterplot smoothing(LOWESS)analysis was conducted to demonstrate reproducibility,and the prognostic value was assessed through multivariate Cox regression analysis and nomogram.Results Serum HBV-DNA load was highly correlated with NICP(P<0.001),and LOWESS analysis showed good reproducibility of the results.Multivariate analysis of the cohort identified NICP,HBV-DNA,TNM staging,and serum alanine transaminase as independent factors affecting overall survival.The survival probabilities based on the corrected curve showed that the nomogram predictions closely matched the actual observations.Conclusion Serum HBV-DNA load can accurately reflect the degree of inflammation in HCC and is of significant value for accurately predicting the survival of HCC patients.

关 键 词：肝细胞癌 乙型肝炎病毒-脱氧核糖核酸载量 汇管区炎细胞数 预后评估 

分 类 号：R73[医药卫生—肿瘤]