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[根据新的分期分类对肝细胞癌的预后评估]

[Prognosis of hepatocellular carcinoma according to new staging classifications].

作者信息

Caselitz M, Masche N, Flemming P, Stern C, Manns M P, Wagner S, Kubicka S

机构信息

Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover.

出版信息

Dtsch Med Wochenschr. 2004 Aug 13;129(33):1725-30. doi: 10.1055/s-2004-829023.

Abstract

BACKGROUND AND OBJECTIVE

We investigated prognostic factors and survival of patients with hepatocellular carcinoma (HCC) in North-Germany. Established staging systems (Child-Pugh, Okuda and UICC classification) were compared with new prognostic scores from Italy (CLIP) and Spain (BCLC).

PATIENTS AND METHODS

The clinical course of 62 consecutive patients (34-82 years, 48 males, 14 females) with HCC observed in the Medical School of Hannover from October 1996 to September 1998 were retrospectively analyzed. The patients were classified according to the staging systems of Child Pugh, Okuda, UICC, CLIP and BCLC. Follow-up ended on December 31 (st) 2001.

RESULTS

Overall median survival was 11,3 (1 - 59,5) months. At univariate analysis (log-rank test) Okuda, UICC, CLIP and BCLC Score were each associated with a shorter survival. In contrast Child Pugh score provided no significant prognostication. By multiple regression analysis (Cox regression analysis), only the CLIP and UICC score and chronic hepatitis B infection were shown to be independent risk factors.

CONCLUSION

Our investigations indicate, that the CLIP and UICC classifications identified those patients with the best prognosis and they, as well as chronic hepatitis C, were shown to be independent risk factors.

摘要

背景与目的

我们调查了德国北部肝细胞癌(HCC)患者的预后因素及生存率。将已确立的分期系统(Child-Pugh、Okuda和UICC分类)与来自意大利(CLIP)和西班牙(BCLC)的新预后评分进行了比较。

患者与方法

回顾性分析了1996年10月至1998年9月在汉诺威医学院观察到的62例连续的HCC患者(年龄34 - 82岁,男性48例,女性14例)的临床病程。根据Child Pugh、Okuda、UICC、CLIP和BCLC的分期系统对患者进行分类。随访于2001年12月31日结束。

结果

总体中位生存期为11.3(1 - 59.5)个月。单因素分析(对数秩检验)显示,Okuda、UICC、CLIP和BCLC评分均与较短的生存期相关。相比之下,Child Pugh评分未提供显著的预后信息。通过多因素回归分析(Cox回归分析),仅CLIP和UICC评分以及慢性乙型肝炎感染被证明是独立的危险因素。

结论

我们的研究表明,CLIP和UICC分类识别出了预后最佳的患者,并且它们以及慢性丙型肝炎被证明是独立的危险因素。

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