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肝移植或肝切除术后肝细胞癌复发的预后因素——单中心经验

Prognostic factors for hepatocellular carcinoma recurrence after liver transplantation or resection - single-center experience.

作者信息

Gryziak Maciej, Stec Rafał, Woźniak Krzysztof, Szczepankiewicz Benedykt, Krasnodębski Maciej, Grąt Michał, Kraj Leszek

机构信息

Medical University of Warsaw, ul. Żwirki i Wigury 61, 02-091, Warsaw, Poland.

Department of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sci-ences, 05-552, Garbatka, Poland.

出版信息

Heliyon. 2024 Nov 13;10(22):e40228. doi: 10.1016/j.heliyon.2024.e40228. eCollection 2024 Nov 30.

Abstract

INTRODUCTION

The aim of the study was to assess prognostic factors associated with an increased risk of recurrence of hepatocellular carcinoma (HCC) after radical treatment.

MATERIALS AND METHODS

This is a retrospective, single-center analysis of data on HCC recurrence in patients who underwent radical treatment. Molecular tumor characteristics, baseline laboratory results and hepatic viral status were analyzed.

RESULTS

Data from 111 patients were included in the analysis. The most important prognostic factors for recurrence were vascular microinvasion (HR 4.54; 95 % CI 1.769-11.681; p 0.001), baseline white blood count (HR 2.13; 95 % CI 1.261-3.567; p 0.004) and baseline alpha-fetoprotein (HR 1.00009; 95 % CI 1.000001-1.00002; p 0.034). Microvascular invasion was only prognostic factor which correlate significantly with the overall survival (HR 5.04, 95 % CI 2.352-12.413; p < 0.001). PD-L1 expression was confirmed in 4 patients and all of them developed a disease recurrence. However, there was no statistically significant assosciation with prognosis. The presence of CD68 tumor-associated macrophages was confirmed in 62 patients, ranging from 5 % to 40 %. Analysis showed that CD68 was not associated with the risk of recurrence of HCC.

CONCLUSIONS

The results confirm that microvascular invasion is the most important factor associated with an increased risk of hepatocellular carcinoma recurrence and death, while PD-L1 and CD68 expression did not have an impact on patient prognosis.

摘要

引言

本研究的目的是评估与肝细胞癌(HCC)根治性治疗后复发风险增加相关的预后因素。

材料与方法

这是一项对接受根治性治疗的HCC患者复发数据的回顾性单中心分析。分析了分子肿瘤特征、基线实验室检查结果和肝脏病毒状态。

结果

111例患者的数据纳入分析。复发的最重要预后因素是血管微侵犯(HR 4.54;95% CI 1.769 - 11.681;p 0.001)、基线白细胞计数(HR 2.13;95% CI 1.261 - 3.567;p 0.004)和基线甲胎蛋白(HR 1.00009;95% CI 1.000001 - 1.00002;p 0.034)。微血管侵犯是唯一与总生存期显著相关的预后因素(HR 5.04,95% CI 2.352 - 12.413;p < 0.001)。4例患者检测到PD-L1表达,且均出现疾病复发。然而,与预后无统计学显著关联。62例患者证实存在CD68肿瘤相关巨噬细胞,范围为5%至40%。分析表明,CD68与HCC复发风险无关。

结论

结果证实微血管侵犯是与肝细胞癌复发和死亡风险增加相关的最重要因素,而PD-L1和CD68表达对患者预后无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96a7/11617879/7643a2aeb2cc/gr1.jpg

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