Han Seung Ho, Han Sang Young, Go Byoung Soung, Kim Min Ji, Lee Jung Hyun, Koo Young Hun, Ryu Seung Hoon, Cho Jeong Hwan, Jang Jin Seok, Lee Jong Hoon, Roh Myung Hwan, Choi Seok Ryeol, Choi Joung Chel, Lee Sung Wook
Department of Internal Medicine, Medical Sciences Research Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea.
Korean J Hepatol. 2006 Jun;12(2):209-20.
BACKGROUNDS/AIMS: The prognosis of cirrhotic patients with hepatocellular carcinoma (HCC) depends on both residual liver function and tumor characteristics. The aims of this study was to construct a new prognostic index for HCC patients: the modified CLIP score, and to compare its discriminatory ability and predictive power with those of the CLIP score that is currently the most commonly used integrated staging score in patients of HCC.
A retrospective analysis of 237 cases of HCC diagnosed at Dong-A university hospital was performed. Prognostic analysis was performed for single variables by estimating survival distributions with the Kaplan-Meier's method, and statistically compared by the log-rank test.
Patients had a mean age of 57.5 years and were predominantly males (79.7%). The overall median survival period was 25.7 months. It was correlated to ascites, portal vein thrombosis, AFP, tumor size, and Child-Pugh classification. The median survival period was 41.0, 25.2, 13.8, 13.4, and 6.5 months for CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001), and 42.1, 34.0, 25.7, 14.0, and 6.8 months for modified CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001). The Kaplan-Meier's curve showed that the modified CLIP score had additional explanatory power above that of the CLIP score.
The modified CLIP score, compared with the CLIP score, particularly in the score 2- to 3- patient groups of HCC, had greater discriminant ability and survival predictive power, but was not able to discriminate 4- to 6- patient group.
背景/目的：肝硬化合并肝细胞癌（HCC）患者的预后取决于残余肝功能和肿瘤特征。本研究旨在构建一种新的HCC患者预后指数：改良CLIP评分，并将其鉴别能力和预测能力与目前HCC患者中最常用的综合分期评分CLIP评分进行比较。
对在东亚大学医院确诊的237例HCC患者进行回顾性分析。采用Kaplan-Meier法估计生存分布对单变量进行预后分析，并通过对数秩检验进行统计学比较。
患者平均年龄57.5岁，以男性为主（79.7%）。总体中位生存期为25.7个月。它与腹水、门静脉血栓形成、甲胎蛋白、肿瘤大小和Child-Pugh分级相关。CLIP评分0、1、2、3以及4至6的患者中位生存期分别为41.0、25.2、13.8、13.4和6.5个月（P<0.001），改良CLIP评分0、1、2、3以及4至6的患者中位生存期分别为42.1、34.0、25.7、14.0和6.8个月（P<0.001）。Kaplan-Meier曲线显示改良CLIP评分比CLIP评分具有额外的解释力。
与CLIP评分相比，改良CLIP评分，尤其是在HCC的2至3分患者组中，具有更强的鉴别能力和生存预测能力，但无法区分4至6分患者组。
