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[乙肝相关肝细胞癌患者肝移植术后肿瘤复发的危险因素分析]

[Analysis of risk factors of tumor recurrence after liver transplantation for HBV-related hepatocellular carcinoma patients].

作者信息

Li Z, Mao Y G, Yu C, Gao J, Zhu J Y

机构信息

Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing100044, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2018 Feb 20;26(2):98-101. doi: 10.3760/cma.j.issn.1007-3418.2018.02.005.

Abstract

To explore the characteristics of tumor recurrence after liver transplantation in patients with hepatocellular carcinoma (HCC) associated with hepatitis B and to analyze the risk factors that influence the recurrence and prognosis. The clinicopathological and survival data of 162 patients with hepatitis B -associated liver cancer who underwent liver transplantation in Peking University People's Hospital from January 2002 to December 2016 were retrospectively analyzed. The postoperative survival rate (OS) and tumor free survival rate (DFS) was statistically analyzed by using the log-rank test. Univariate analysis was performed for various clinicopathological indicators, and the Cox proportional risk regression model was used for multivariate analysis. Univariate analysis showed that the age of the recipients ((OS) = 0.047, (DFS) = 0.045), the maximum tumor size ( < 0.001, (DFS) < 0.001), preoperative AFP levels ((OS) < 0.001, (DFS) < 0.001), preoperative HBV-DNA levels ((OS) = 0.035, (DFS) = 0.029), vein tumor thrombosis ((OS) < 0.001, (DFS) < 0.001), and tumor differentiation degree ((OS) <0.001, (DFS) < 0.001) were associated with overall prognosis and tumor recurrence. Multivariate analysis revealed that preoperative AFP levels ((OS) = 0.014, (DFS) = 0.013), the maximum tumor size ((OS) < 0.001, (DFS) = 0.001), vein tumor thrombosis ((OS) = 0.012, (DFS) < 0.004), and tumor differentiation degree ((OS) = 0.004, (DFS) = 0.009) were independent risk factors affecting overall prognosis and tumor recurrence. The major prognostic factors linked to tumor biological characteristics after liver transplantation in HBV-related HCC patients are preoperative AFP levels, the largest tumor size, and vein tumor thrombosis and tumor differentiation degree.

摘要

探讨乙型肝炎相关肝细胞癌(HCC)患者肝移植后肿瘤复发的特点,并分析影响复发及预后的危险因素。回顾性分析2002年1月至2016年12月在北京大学人民医院接受肝移植的162例乙型肝炎相关肝癌患者的临床病理及生存资料。采用对数秩检验对术后生存率(OS)和无瘤生存率(DFS)进行统计学分析。对各项临床病理指标进行单因素分析,并采用Cox比例风险回归模型进行多因素分析。单因素分析显示,受者年龄((OS)=0.047,(DFS)=0.045)、肿瘤最大径((OS)<0.001,(DFS)<0.001)、术前甲胎蛋白(AFP)水平((OS)<0.001,(DFS)<0.001)、术前乙肝病毒脱氧核糖核酸(HBV-DNA)水平((OS)=0.035,(DFS)=0.029)、静脉瘤栓((OS)<0.001,(DFS)<0.001)以及肿瘤分化程度((OS)<0.001,(DFS)<0.001)与总体预后和肿瘤复发相关。多因素分析显示,术前AFP水平((OS)=0.014,(DFS)=0.013)、肿瘤最大径((OS)<0.001,(DFS)=0.001)、静脉瘤栓((OS)=0.012,(DFS)<0.004)以及肿瘤分化程度((OS)=0.004,(DFS)=0.009)是影响总体预后和肿瘤复发的独立危险因素。乙型肝炎相关肝癌患者肝移植后与肿瘤生物学特性相关的主要预后因素是术前AFP水平、肿瘤最大径、静脉瘤栓以及肿瘤分化程度。

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