[1]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.
 LI Chuanhong,DENG Yong,OU Yanjiao,et al.Hepatocellular carcinoma recurrence within 2 years after radical resection: risk factors and a prediction model[J].J Third Mil Med Univ,2018,40(24):2249-2253.
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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(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第24期
页码:
2249-2253
栏目:
临床医学
出版日期:
2018-12-30

文章信息/Info

Title:
Hepatocellular carcinoma recurrence within 2 years after radical resection: risk factors and  a prediction model
作者:
李传红邓永欧晏娇张雷达
陆军军医大学(第三军医大学)第一附属医院肝胆外科
Author(s):
LI Chuanhong DENG Yong OU Yanjiao ZHANG Leida

Department of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
肝癌根治性切除术肝癌肝癌复发预测系统
Keywords:
hepatocellular carcinoma radical resection recurrence prediction model
分类号:
R730.56;R730.7;R735.7
文献标志码:
A
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 (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-(1-0.891X1)×( 1-0.638X2)×(1-0.737X3)×(1-0.754X4) (X1-X4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 recurrence 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-(1-0.891X1)×(1-0.638X2) × (1-0.737X3) × (1-0.754X4), where X1, X2, X3, and X4 were preoperative AFP level, tumor number, HBVDNA positive and ICGR15, respectively. Conclusion    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.
 

参考文献/References:

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更新日期/Last Update: 2019-01-02