原发性肝癌术后复发预测模型构建及评价  

Construction and Evaluation for Postoperative Recurrence Prediction Model of Hepatocellular Carcinoma

作　　者：杨宏志[1] 唐毓林[1] 许景洪[1] 李立志[1] 李业钊[1] YANG Hongzhi;TANG Yulin;XU Jinghong;LI Lizhi;LI Yezhao(Department of Hepatobiliary Gastrointestinal Surgery,Minzu Hospital of Guangxi Zhuang Autonomous Region,Guangxi Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院肝胆胃肠外科,广西南宁530001

出　　处：《转化医学杂志》2024年第11期1944-1948,共5页Translational Medicine Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210846)。

摘　　要：目的研究手术治疗肝细胞癌(HCC)患者的预后及其影响因素。方法选取2010年6月至2022年5月在广西壮族自治区民族医院接受手术治疗的475例HCC患者,观察其死亡或复发情况,采用逐步多元Logistics回归建立预后模型,绘制Nomgram图、ROC曲线评估模型效果。结果475例患者中死亡191例(40.21%),复发220例(46.32%)。多因素Logistics回归分析显示,合并高血压病(HTN)、饮酒、微血管和自噬基因Beclin1(Beclin1T)是患者死亡的危险因素。此外,年龄超过65岁、饮酒、治疗前血清白蛋白(pre_Alb)、治疗前凝血酶原时间(pre_PT)、HCC_differentiated和微血管是患者复发的危险因素。结论影响HCC手术患者死亡与复发的因素包括性别、饮酒、微血管、肿瘤部分的微管相关蛋白1轻链3(LC3T)和非肿瘤部分的微管相关蛋白1轻链3(LC3NT),Nomgram图对指导治疗有重要意义,建议采取针对性干预措施。Objective To investigate the prognosis and influencing factors of patients with hepatocellular carcinoma(HCC)treated by surgery.Methods In this study,475 HCC patients who received surgical treatment in Minzu Hospital of Guangxi Zhuang Autonomous Region from June 2010 to May 2022 were included to observe their death or recurrence.The prognosis model was established by stepwise multiple logistics regression,and Nomgram graph,ROC curve were drawn to evaluate the model effect.Results Among 475 patients,191(40.21%)died and 220(46.32%)relapsed.Multi-factor logistics regression analysis showed that combined HTN,alcohol consumption,microvascular and Beclin1T were risk factors for patient death.In addition,being older than 65 years,alcohol consumption,pre_Alb,pre_PT,HCC_differentiated,and microvascular were risk factors for relapse.Conclusion Factors affecting death and recurrence of HCC patients after surgery include gender,alcohol consumption,microvascular,LC3T and LC3NT.Nomgram is of great significance to guide treatment,and targeted intervention measures are recommended.

关 键 词：原发性肝癌 手术治疗 预后 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]