根治性肝切除术后肝细胞癌复发中的性别差异。

Gender disparity in hepatocellular carcinoma recurrence after curative hepatectomy.

作者信息

Liang Tianyi, He Yongfei, Mo Shutian, Chen Zijun, Liao Xiwen, Zhou Xin, Yang Chengkun, Zhao Shuqi, Han Chuangye, Zhu Guangzhi, Su Hao, Ye Xinping, Peng Tao

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.

出版信息

Ann Hepatol. 2022 May-Jun;27(3):100695. doi: 10.1016/j.aohep.2022.100695. Epub 2022 Mar 5.

DOI:10.1016/j.aohep.2022.100695

PMID:35257933

Abstract

INTRODUCTION AND OBJECTIVES

Whether there is gender disparity in the recurrence of hepatocellular carcinoma (HCC) has been not fully addressed. This study aimed to investigate the impact of gender on HCC recurrence following curative hepatectomy.

PATIENTS AND METHODS

This retrospective cohort study included 1087 patients with HCC (917 males, 170 females) who underwent curative hepatectomy. Cox regression models were constructed to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the risk parameters associated with HCC recurrence. In the sensitivity analysis, subgroup analysis, and propensity score matching (PSM) analysis were used. Logistic regression models were used to assess the odds ratio (OR) and 95% CI of the risk parameters related to early and late recurrence.

RESULTS

Male patients showed significantly higher risk for HCC recurrence than females, in both multivariate Cox regression analysis (HR [95% CI] = 1.480 [1.084-2.020], P = 0.014) and PSM analysis (HR [95% CI] = 1.589 [1.093-2.312], P = 0.015). Higher risk of HCC recurrence was again found in males in the subgroup analysis, but the effect of male versus female gender on HCC recurrence did not depend on any selected subgroups (all P for interaction > 0.05). Gender was an independent risk factor for early recurrence (OR [95% CI] = 1.864 [1.215-2.936], P = 0.006), but not for late recurrence.

CONCLUSIONS

There is gender disparity in the recurrence of patients with HCC after curative hepatectomy: males had a higher risk for HCC recurrence than females.

摘要

引言与目的

肝细胞癌（HCC）复发中是否存在性别差异尚未得到充分探讨。本研究旨在调查性别对根治性肝切除术后HCC复发的影响。

患者与方法

这项回顾性队列研究纳入了1087例行根治性肝切除的HCC患者（男性917例，女性170例）。构建Cox回归模型以估计与HCC复发相关的风险参数的风险比（HR）和95%置信区间（CI）。在敏感性分析中，采用了亚组分析和倾向评分匹配（PSM）分析。使用逻辑回归模型评估与早期和晚期复发相关的风险参数的比值比（OR）和95%CI。

结果

在多变量Cox回归分析（HR[95%CI]=1.480[1.084 - 2.020]，P = 0.014）和PSM分析（HR[95%CI]=1.589[1.093 - 2.312]，P = 0.015）中，男性患者HCC复发风险均显著高于女性。亚组分析中再次发现男性HCC复发风险较高，但男性与女性性别对HCC复发的影响不依赖于任何选定的亚组（所有交互作用P>0.05）。性别是早期复发的独立危险因素（OR[95%CI]=1.864[1.215 - 2.936]，P = 0.006），但不是晚期复发的危险因素。