Zhuge Yuzheng, Zhang Feng, Qiu Yudong, Li Zhenlei, Zhang Jianwu
Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Hepatogastroenterology. 2013 May;60(123):481-8. doi: 10.5754/hge12003.
BACKGROUND/AIMS: To compare the performance of the Child-Turcotte-Pugh (CTP), the Okuda, the Cancer of Liver Italian Program (CLIP), the Barcelona Clinic Liver Cancer (BCLC), the Chinese staging (CS), Chinese university prognostic index (CUPI), Japan integrated staging (JIS), the Tokyo and the French staging systems, in predicting the survival of patients with primary liver cancer (PLC) receiving transarterial chemoembolization (TACE).
The clinical data of patients undergoing TACE in our department were retrospectively analyzed and compared with the 9 staging systems based on survival after TACE.
A cohort of 60 patients was involved. The survival curves showed that Okuda, BCLC, CS and JIS had better discriminatory ability. By the Cox regression model, Okuda, CS and JIS showed a stronger significance on prognosis. The staging systems with smaller value of -2Ln(L), Akaike Information criterion (AIC) and Schwarz-Bayesian criterion (SBC) were CS, JIS, CLIP and BCLC. An analysis involving 11 factors by Cox model indicated that ascites and vascular invasion were independent prognostic factors.
JIS provides better prognostic stratification for a cohort of the patients with PLC receiving TACE. However, studies with larger samples are still required.
背景/目的：比较Child-Turcotte-Pugh（CTP）、奥田、意大利肝癌项目（CLIP）、巴塞罗那临床肝癌（BCLC）、中国分期（CS）、中国大学预后指数（CUPI）、日本综合分期（JIS）、东京和法国分期系统在预测接受经动脉化疗栓塞术（TACE）的原发性肝癌（PLC）患者生存情况方面的表现。
对在我科接受TACE治疗的患者的临床资料进行回顾性分析，并与基于TACE术后生存情况的9种分期系统进行比较。
纳入了60例患者。生存曲线显示奥田、BCLC、CS和JIS具有更好的区分能力。通过Cox回归模型，奥田、CS和JIS对预后显示出更强的显著性。-2Ln(L)值、赤池信息准则（AIC）和施瓦茨贝叶斯准则（SBC）较小的分期系统为CS、JIS、CLIP和BCLC。通过Cox模型对11个因素进行分析表明，腹水和血管侵犯是独立的预后因素。
JIS为接受TACE治疗的PLC患者队列提供了更好的预后分层。然而，仍需要更大样本量的研究。
