Carr Brian, Donghia Rossella, Yilmaz Sezai
Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.
National Institute of Gastroenterology, IRCCS "Saverio de Bellis", Bari, Italy.
Oncology. 2024 Dec 9:1-10. doi: 10.1159/000542774.
Presence of macroscopic portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC) has been found to be a major poor prognosis characteristic.
The aim of the study was to examine patients with PVT for their clinical characteristics and factors related to both PVT and survival.
A large HCC database containing 1,094 patients with PVT and 2,513 patients without PVT was examined. Patients had routine baseline serum liver parameters and alpha-fetoprotein (AFP) levels measured, as well as radiological assessment of maximum tumor diameter (MTD), tumor number, presence of macroscopic PVT, plus survival.
The percent of patients with PVT increased with increase in both MTD and serum AFP levels and liver parameter levels were worse in patients with PVT than without it. A logistic regression model showed that the combination of MTD >5 cm plus AFP >100 IU/mL plus albumin <3.5 g/dL had an odds ratio of 10.988 for the presence of PVT. Normal serum albumin levels significantly reduced the hazard ratio for death in a Cox proportional hazard model and were associated with decreased liver failure.
Logistic regression showed the significance of MTD, AFP, and albumin in the presence of PVT, and the Cox model highlighted the importance of albumin levels in decreasing death.
肝细胞癌（HCC）患者中存在肉眼可见的门静脉血栓形成（PVT）已被发现是一个主要的预后不良特征。
本研究的目的是检查患有PVT的患者的临床特征以及与PVT和生存相关的因素。
检查了一个大型HCC数据库，其中包含1094例患有PVT的患者和2513例未患有PVT的患者。对患者进行了常规基线血清肝脏参数和甲胎蛋白（AFP）水平的测量，以及对最大肿瘤直径（MTD）、肿瘤数量、肉眼可见PVT的存在情况以及生存情况的影像学评估。
患有PVT的患者百分比随着MTD和血清AFP水平的升高而增加，并且患有PVT的患者的肝脏参数水平比未患PVT的患者更差。逻辑回归模型显示，MTD>5 cm加上AFP>100 IU/mL加上白蛋白<3.5 g/dL的组合对于存在PVT的比值比为10.988。在Cox比例风险模型中，正常血清白蛋白水平显著降低了死亡风险比，并且与肝衰竭的减少相关。
逻辑回归显示了MTD、AFP和白蛋白在存在PVT时的重要性，并且Cox模型突出了白蛋白水平在降低死亡方面的重要性。
