伴有脂肪性肝病和乙型肝炎病毒的肝细胞癌患者中，根据总肿瘤体积或肿瘤负荷评分预测的生存率比较。

Comparison of survival rates as predicted by total tumor volume or tumor burden score in patients with hepatocellular carcinoma concurrent with fatty liver disease and hepatitis B virus.

作者信息

Li Min-Jun, Xie Si, Teng Yu-Xian, Ma Liang, Li Le-Qun, Xiang Bang-De, Zhong Jian-Hong

机构信息

Hepatobiliary Surgery Department, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning, China.

Ministry of Education; Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Nanning, China.

出版信息

Expert Rev Gastroenterol Hepatol. 2023 May;17(5):499-507. doi: 10.1080/17474124.2023.2196403. Epub 2023 Apr 3.

DOI:10.1080/17474124.2023.2196403

PMID:36975382

Abstract

OBJECTIVES

To analyze prognostic value of total tumor volume (TTV) and tumor burden score (TBS) in surgically treated patients with hepatocellular carcinoma and concurrent fatty liver disease and hepatitis B virus (FLD-HCC).

METHODS

FLD-HCC patients who treated with hepatectomy from 2010 to 2018 were analyzed. Prognostic performance of TTV and TBS was determined by ROC analysis. Patients were stratified into low and high tumor burden by optimal cutoff value of 113.4 cm for TTV or 6.3 points for TBS. Survival rates were compared between subgroups and independent risk factors were identified by Cox regression. Correlation between TTV and TBS was evaluated.

RESULTS

This study enrolled 342 FLD-HCC patients. Survival was significantly higher among patients with low tumor burden than among those with high tumor burden ( < 0.001). High TTV and TBS were independent risk factors for poor survival of FLD-HCC (HR: 3.27 (2.17-4.93) and 3.48 (2.31-5.26), respectively, all < 0.001). ROC analyses revealed that TTV and TBS had comparable discriminative ability in stratifying overall and recurrence-free survival of FLD-HCC. Correlation analysis revealed a strong correlation between TTV and TBS.

CONCLUSIONS

Both TTV and TBS have comparable prognostic value and high TTV/TBS predicts poor survival of patients with FLD-HCC.

摘要

目的

分析总肿瘤体积（TTV）和肿瘤负荷评分（TBS）在接受手术治疗的肝细胞癌合并脂肪性肝病和乙型肝炎病毒（FLD-HCC）患者中的预后价值。

方法

分析2010年至2018年接受肝切除术的FLD-HCC患者。通过ROC分析确定TTV和TBS的预后性能。根据TTV的最佳截断值113.4 cm或TBS的6.3分将患者分为低肿瘤负荷和高肿瘤负荷组。比较亚组之间的生存率，并通过Cox回归确定独立危险因素。评估TTV和TBS之间的相关性。

结果

本研究纳入了342例FLD-HCC患者。低肿瘤负荷患者的生存率显著高于高肿瘤负荷患者（<0.001）。高TTV和TBS是FLD-HCC患者生存不良的独立危险因素（HR分别为3.27（2.17-4.93）和3.48（2.31-5.26），均<0.001）。ROC分析显示，TTV和TBS在分层FLD-HCC患者的总生存和无复发生存方面具有相当的判别能力。相关性分析显示TTV和TBS之间存在强相关性。