Li Qun, Lyu Zhuozhen, Wang Liguang, Li Feifei, Yang Zhen, Ren Wanhua
Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People's Republic of China.
Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, People's Republic of China.
Onco Targets Ther. 2020 Mar 20;13:2377-2384. doi: 10.2147/OTT.S242034. eCollection 2020.
The aim of this study was to investigate the prognostic significance of preoperative AAPR in hepatitis B virus-related hepatocellular carcinoma patients after curative hepatectomy.
A total of 221 patients with hepatitis B virus-related HCC patients who received curative liver resection were included. After propensity matching analysis, 188 patients were enrolled in the final analysis. COX regression analyses were used to analyze the prognosis value of AAPR and other prognostic factors. The overall survival (OS) and recurrence-free survival (RFS) curves were constructed and compared between different groups.
The optimal cutoff of AAPR was defined as 0.40 with X-tile software. According to cutoff value, patients were divided into low-AAPR group (≤0.40) and high-AAPR group (>0.40). The cumulative 1-, 3-, and 5-year OS rates were 97.1%, 78.2%, and 67.3% in patients with AAPR>0.40 group, respectively, which were significantly higher than those in the AAPR≤0.40 group (80.2%, 54.4%, and 40.1%, respectively) (P <0.001). In the multivariate COX regression analysis, AAPR, tumor number, ascites, and portal vein tumor thrombus (PVTT) were independent risk factors for OS and RFS.
AAPR shows promise as a reliable prognostic factor in patients with hepatitis B virus-related HCC after curative hepatectomy, which could be used as a routine inspection of HCC patients before surgery.
本研究旨在探讨术前AAPR在乙型肝炎病毒相关肝细胞癌患者根治性肝切除术后的预后意义。
纳入221例接受根治性肝切除的乙型肝炎病毒相关肝癌患者。经过倾向匹配分析后,188例患者纳入最终分析。采用COX回归分析来分析AAPR及其他预后因素的预后价值。构建不同组之间的总生存(OS)和无复发生存(RFS)曲线并进行比较。
使用X-tile软件将AAPR的最佳截断值定义为0.40。根据截断值,患者分为低AAPR组(≤0.40)和高AAPR组(>0.40)。AAPR>0.40组患者的1年、3年和5年累积总生存率分别为97.1%、78.2%和67.3%,显著高于AAPR≤0.40组(分别为80.2%、54.4%和40.1%)(P<0.001)。在多因素COX回归分析中,AAPR、肿瘤数量、腹水和门静脉癌栓(PVTT)是OS和RFS的独立危险因素。
AAPR有望成为乙型肝炎病毒相关肝癌患者根治性肝切除术后可靠的预后因素,可作为肝癌患者术前的常规检查项目。