400038 重庆,陆军军医大学(第三军医大学)第一附属医院肝胆外科
Received:05 July 2018,
Revised:2018-09-08,
Published:30 December 2018
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Chuanhong LI, Yong DENG, Yanjiao OU, et al. Hepatocellular carcinoma recurrence within 2 years after radical resection: risk factors and a prediction model[J]. Journal of Third Military Medical University, 2018, 40(24): 2249-2253.
Chuanhong LI, Yong DENG, Yanjiao OU, et al. Hepatocellular carcinoma recurrence within 2 years after radical resection: risk factors and a prediction model[J]. Journal of Third Military Medical University, 2018, 40(24): 2249-2253. DOI: 10.16016/j.1000-5404.201807041.
目的
2
探讨肝癌根治性切除术后肝癌复发的高危因素并初步建立肝癌复发预测系统。
方法
2
回顾性分析西南医院及东方肝胆医院、西京医院、中山大学肿瘤防治中心2014年1月至2016年5月期间收治的421例住院行肝癌根治性切除术患者的完整病历资料,单因素分析采用pearson卡方检验,多因素分析采用二分类Logistic回归分析,各因素对肝癌根治术后复发的预测价值采用概率回归分析。
结果
2
421例患者共发生肝癌复发169例,单因素分析及多因素分析提示术前AFP、HBV-DNA阳性、肿瘤数目及ICGR15是肝癌根治性切除术后肝癌复发的高危因素(
P
=0.021
0.008
0.035
0.006)。根据概率回归分析结果,设立术后2年内肝癌复发风险=1-(1-0.891X
1
)×(1-0.638X
2
)× (1-0.737X
3
)×(1-0.754X
4
) (X
1
-X
4
分别为术前AFP、肿瘤数目、HBV-DNA及ICGR15的指标得分)。
结论
2
术前AFP、HBV-DNA、肿瘤数目及ICGR15是肝癌根治性切除术后肝癌复发的高危因素,对肝癌复发具有预测价值。初步建立的肝癌复发预测系统具有一定临床意义,有助于肝癌患者个体化治疗方案的制定。
Objective
2
To identify the risk factors for recurrence of hepatocellular carcinoma (HCC) after radical resection and establish a prediction model based on these risk factors.
Methods
2
We retrospectively analyzed the clinical data of 421 patients with HCC undergoing radical hepatectomy in our Hospital
Oriental Hepatobiliary Hospital
Xijing Hospital and Cancer Prevention and Treatment Center of Sun Yat-sen University between January
2014 and May
2016. Univariate analysis was performed using Pearson
Chi
-square test
and multivariate analysis was performed using binary logistic regression analysis
to identify the risk factors of HCC recurrence within 2 years after radical resection. The predictive value of each factor for HCC recurrence was determined using probability regression analysis.
Results
2
Of the 421 patients undergoing radical resection
169 had rec urrence of HCC within 2 years after the operation. Univariate analysis and multivariate analysis showed that preoperative α-fetoprotein (AFP) level (
P
=0.021)
HBV-DNA positive (
P
= 0.008)
tumor number (
P
=0.035) and indocyanine green retention rate at 15 min (ICGR15;
P
=0.006) were risk factors for HCC recurrence after radical hepatectomy. Based on the results of multivariate linear regression analysis
we established a prediction model for risks of HCC recurrence within 2 years after operation: y=1-(1-0.891
X
1
)×(1-0.638
X
2
) × (1 - 0.737
X
3
) × (1-0.754
X
4
)
where
X
1
X
2
X
3
and
X
4
were preoperative AFP level
tumor number
HBV-DNA positive and ICGR15
respectively.
Conclusion
2
A
high preoperative AFP level
a high HBV-DNA level
a greater tumor number and a high ICGR15 are all high-risk factors for predicting HCC recurrence after radical hepatectomy. The prediction model for HCC recurrence established herein based on these 4 factors can be helpful for devising individualized treatment plan for patients with HCC.
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