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食管胃静脉曲张对肝细胞癌患者预后的影响。

The impact of esophagogastric varices on the prognosis of patients with hepatocellular carcinoma.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Sci Rep. 2017 Feb 17;7:42577. doi: 10.1038/srep42577.

Abstract

Whether or not esophagogastric varices (EGV) could determine the outcomes of patients with hepatocellular carcinoma (HCC) is still unclear. A total of 990 treatment-naive HCC patients who received an esophagogastroduodenoscopy at the time of HCC diagnosis were retrospectively enrolled. The factors in terms of prognosis were analyzed by Cox proportional hazards model and propensity score matching analysis. Among the enrolled patients, 480 (48.5%) patients had EGV. Patients with EGV had a significantly lower cumulative 5-year survival rate than those without EGV (24.9% versus 46.4%, p < 0.001). It was confirmed by a multivariate analysis and propensity score matching analysis. Stratified by tumor stage, the patients with EGV had lower survival rates than the patients without EGVs in all Barcelona Clinic Liver Cancer stages except stage D. Moreover, the patients with EGV had lower survival rates than those without EGV, both by curative or non-curative treatment modalities. In conclusion, EGV was an independent risk factor predicting poor prognosis for the patients with HCC by multivariate analysis, propensity score matching analysis, and subgroup analysis.

摘要

食管胃静脉曲张(EGV)是否能决定肝细胞癌(HCC)患者的预后尚不清楚。本研究回顾性纳入了 990 例在 HCC 诊断时接受食管胃十二指肠镜检查的初治 HCC 患者。采用 Cox 比例风险模型和倾向评分匹配分析对预后相关因素进行分析。在纳入的患者中,480 例(48.5%)存在 EGV。与无 EGV 者相比,EGV 患者的累积 5 年生存率显著较低(24.9%比 46.4%,p<0.001)。多变量分析和倾向评分匹配分析也证实了这一点。分层分析肿瘤分期后,除 D 期外,所有巴塞罗那临床肝癌分期的 EGV 患者的生存率均低于无 EGV 患者。此外,无论采用根治性或非根治性治疗方法,EGV 患者的生存率均低于无 EGV 患者。总之,多变量分析、倾向评分匹配分析和亚组分析均表明,EGV 是预测 HCC 患者预后不良的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2303/5314332/81a183d6a83b/srep42577-f1.jpg

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