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糖尿病影响乙型肝炎病毒相关性肝细胞癌患者的长期生存:倾向评分匹配分析。

Diabetes mellitus affects long-term survival in hepatitis B virus-related hepatocellular carcinoma patients: A propensity score-matched analysis.

机构信息

Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu.

Liver transplantation center, Beijing friendship hospital, capital medical university. 101 Luyuan east road, Tongzhou district, Beijing, China.

出版信息

Medicine (Baltimore). 2021 Jan 29;100(4):e24354. doi: 10.1097/MD.0000000000024354.

Abstract

Diabetes mellitus (DM) increases the risk of developing hepatocellular carcinoma (HCC), and how DM affects the prognosis of HCC have not been elucidated. The aim of this study was to compare clinicopathological characteristics and survival between hepatitis B virus (HBV)-related HCC patients with and without DM and to determine risk factors for overall survival after hepatectomy.Among 474 patients with HBV-related HCC, 119 patients had DM. Patients were divided into the diabetic group and nondiabetic group. The short-term and long-term outcomes were evaluated by using propensity score matching analysis.After 1:2 propensity score matching, there were 107 patients in diabetic group, 214 patients in nondiabetic group. The proportion of vessels invasion were higher in diabetic group. The overall survival rate in the diabetic group was 44.7% at 3 years, which was lower than that in the nondiabetic group (56.1%, P = .025). The multivariate analysis indicated that fasting blood glucose >7.0, capsular invasion, microvascular invasion and satellite were independent risk factor of poor prognosis in HCC.DM dose affect the recurrence-free survival and overall survival in HBV-related HCC patients after hepatectomy. One of the more significant findings to emerge from this study is that DM induced higher proportion of major vessel invasion in HCC patients implied unfavorable prognosis.

摘要

糖尿病(DM)增加了发生肝细胞癌(HCC)的风险,但 DM 如何影响 HCC 的预后尚未阐明。本研究旨在比较乙型肝炎病毒(HBV)相关 HCC 患者中有无 DM 的临床病理特征和生存情况,并确定肝切除术后总生存率的危险因素。

在 474 例 HBV 相关 HCC 患者中,有 119 例患有 DM。患者分为糖尿病组和非糖尿病组。采用倾向性评分匹配分析评估短期和长期结果。

经过 1:2 倾向性评分匹配后,糖尿病组有 107 例患者,非糖尿病组有 214 例患者。糖尿病组血管侵犯的比例较高。糖尿病组的 3 年总生存率为 44.7%,低于非糖尿病组(56.1%,P = .025)。多因素分析表明,空腹血糖>7.0、包膜侵犯、微血管侵犯和卫星是 HCC 预后不良的独立危险因素。

DM 确实会影响 HBV 相关 HCC 患者肝切除术后的无复发生存率和总生存率。本研究的一个更显著的发现是,DM 导致 HCC 患者中较大血管侵犯的比例更高,提示预后不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c9/7850751/f1ffde5c6e8d/medi-100-e24354-g001.jpg

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