糖尿病会影响接受肝癌移植手术患者的大血管侵犯风险。
Diabetes mellitus impacts risk of macrovascular invasion in patients undergoing transplantation for hepatocellular carcinoma.
机构信息
The Department of Medicine, James P, Wilmot Cancer Center, and, University of Rochester, Rochester, NY, USA.
出版信息
BMC Gastroenterol. 2013 Jan 14;13:9. doi: 10.1186/1471-230X-13-9.
BACKGROUND
Diabetes mellitus (DM) is identified as a negative prognostic indicator in hepatocellular carcinoma (HCC), though the basis for this is unknown.
METHODS
This is a retrospective analysis of a prospectively collected database of 191 HCC patients treated at the University of Rochester Medical Center (URMC) with orthotopic liver transplantation between 1998-2008. Clinical characteristics were compared between patients with and without DM prior to liver transplantation and logistic regression analyses were conducted to assess the effect of DM on clinical outcomes including vascular invasion.
RESULTS
Eighty-four of 191 (44%) transplanted patients had DM at time of transplantation. An association of DM with invasive disease was found among transplanted HCC patients where histologically confirmed macrovascular invasion was found in 20.2% (17/84) of diabetics compared to 9.3% of non-diabetics (10/107) (p=0.032). This difference also remained significant when adjusting for tumor size, number of nodules, age, obesity and etiologic risk factors in multivariate logistic regression analysis (OR=3.2, p=0.025).
CONCLUSIONS
DM is associated with macrovascular invasion among a cohort of transplanted HCC patients.
背景
糖尿病（DM）被认为是肝细胞癌（HCC）的预后不良指标，但其基础尚不清楚。
方法
这是对罗切斯特大学医学中心（URMC）在 1998 年至 2008 年间进行的 191 例 HCC 患者接受原位肝移植的前瞻性收集数据库进行的回顾性分析。比较了移植前有和没有糖尿病的患者的临床特征，并进行了逻辑回归分析，以评估 DM 对包括血管侵犯在内的临床结局的影响。
结果
在 191 例接受移植的患者中，有 84 例（44%）患有 DM。在接受肝移植的 HCC 患者中，DM 与侵袭性疾病相关，其中经组织学证实的大血管侵犯在糖尿病患者中为 20.2%（17/84），而非糖尿病患者中为 9.3%（10/107）（p=0.032）。在多变量逻辑回归分析中，当调整肿瘤大小、结节数量、年龄、肥胖和病因危险因素时，这种差异仍然显著（OR=3.2，p=0.025）。
结论
DM 与接受移植的 HCC 患者中的大血管侵犯有关。
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