肝癌根治性切除术后肝癌复发影响因素的临床研究及预测系统的初步探索

李传红; 邓永; 欧晏娇; 张雷达

doi:10.16016/j.1000-5404.201807041

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肝癌根治性切除术后肝癌复发影响因素的临床研究及预测系统的初步探索

临床医学 | 更新时间：2026-01-09

- 肝癌根治性切除术后肝癌复发影响因素的临床研究及预测系统的初步探索
- Hepatocellular carcinoma recurrence within 2 years after radical resection: risk factors and a prediction model
- 第三军医大学学报 2018年40卷第24期页码：2249-2253
- 作者机构：
  
  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
- 作者简介：
  
  [张雷达, E-mail：2518569931@qq.com ZHANG Leida, E-mail: 2518569931@qq.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201807041
  中图分类号： R730.56;R730.7;R735.7
- 收稿：2018-07-05，
  
  修回：2018-09-08，
  
  纸质出版：2018-12-30
- 稿件说明：
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李传红, 邓永, 欧晏娇, 等. 肝癌根治性切除术后肝癌复发影响因素的临床研究及预测系统的初步探索[J]. 第三军医大学学报, 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.
李传红, 邓永, 欧晏娇, 等. 肝癌根治性切除术后肝癌复发影响因素的临床研究及预测系统的初步探索[J]. 第三军医大学学报, 2018,40(24):2249-2253. DOI： 10.16016/j.1000-5404.201807041.

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.

摘要

目的

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

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

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(

=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

)×(1-0.638X

)× (1-0.737X

)×(1-0.754X

) (X

-X

分别为术前AFP、肿瘤数目、HBV-DNA及ICGR15的指标得分)。

结论

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。

Abstract

Objective

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

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

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 (

=0.021)

HBV-DNA positive (

= 0.008)

tumor number (

=0.035) and indocyanine green retention rate at 15 min (ICGR15;

=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

)×(1-0.638

) × (1 - 0.737

) × (1-0.754

)

where

and

were preoperative AFP level

tumor number

HBV-DNA positive and ICGR15

respectively.

Conclusion

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.

关键词

Keywords

references

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