Department of Hepatology, Yantai Infectious Disease Hospital, Yantai, Shandong, China.
Department of Oncology, Yantai Yuhuangding Hospital, Yantai, Shandong, China.
J Int Med Res. 2020 Apr;48(4):300060520908763. doi: 10.1177/0300060520908763.
To investigate the prognostic value of change in liver stiffness following surgery, in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
Patients with HBV-related HCC were included. Preoperative (baseline) liver stiffness and postoperative dynamic change in liver stiffness was evaluated.
Out of 158 patients in total, postoperative liver stiffness was increased in 98 patients and decreased in 60 patients compared with baseline values. Kaplan-Meier analysis revealed that patients with elevated liver stiffness had significantly worse overall survival outcomes than those with decreased liver stiffness. Similar trends were observed for diseases-free survival and recurrence outcomes. Multivariate analyses showed that Child–Turcotte–Pugh score (hazard ratio [HR] 1.209) and liver stiffness changes (HR 1.891) were independent factors associated with overall survival. Liver stiffness changes (HR 1.521) and α-fetoprotein level (HR 1.210) were found to be independent factors for disease-free survival in patients with HCC.
Increased postoperative liver stiffness may be an independent risk factor of HCC prognosis. Patients with increased liver stiffness following surgery should undergo additional examinations during follow-up.
探讨乙型肝炎病毒（HBV）相关肝细胞癌（HCC）患者术后肝硬度变化的预后价值。
纳入 HBV 相关 HCC 患者。评估术前（基线）肝硬度和术后肝硬度的动态变化。
在总共 158 例患者中，与基线值相比，98 例患者术后肝硬度增加，60 例患者术后肝硬度降低。Kaplan-Meier 分析显示，肝硬度升高的患者总生存结局明显差于肝硬度降低的患者。无病生存和复发结局也呈现出类似的趋势。多变量分析显示，Child–Turcotte–Pugh 评分（风险比 [HR] 1.209）和肝硬度变化（HR 1.891）是与总生存相关的独立因素。对于 HCC 患者，肝硬度变化（HR 1.521）和甲胎蛋白水平（HR 1.210）是无病生存的独立因素。
术后肝硬度增加可能是 HCC 预后的独立危险因素。术后肝硬度增加的患者在随访期间应进行额外的检查。
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