摘要
目的 探讨肝细胞癌(HCC)切除术后早期复发的危险因素,评估白蛋白-胆红素(ALBI)评分对HCC切除术后早期复发的预测价值。方法 回顾性分析2016年1月至2020年12月郑州大学第一附属医院肝胆胰外一科诊断为HCC并行肝切除术病人的临床资料,根据术后2年内是否复发分为早期复发组(n=63,2年内复发)和非早期复发组(n=75,2年内未复发)。分析病人早期复发的危险因素,采用Kaplan-Meier法和Log-Rank检验比较不同等级ALBI组病人的无瘤生存率。结果 早期复发组和非早期复发组在肿瘤直径、微血管侵犯(MVI)、碱性磷酸酶、甲胎蛋白、ALBI分级方面差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,肿瘤直径(OR=2.201,95%CI 1.055~4.594,P=0.036)、MVI(OR=2.425,95%CI 1.058~5.562,P=0.036)和ALBI分级(OR=2.442,95%CI 1.130~5.279,P=0.023)是HCC切除术后早期复发的独立危险因素。不同等级ALBI组病人在术后6个月、1年、2年内复发存在差异(P<0.05)。Kaplan-Meier无复发生存曲线显示高分级ALBI组病人复发率高于低分级ALBI组,差异有统计学意义(P<0.05)。结论 术前ALBI评分对HCC切除术后早期复发有一定的预测价值,可用于HCC病人术后复发风险分层。
Objective To investigate the risk factors of early recurrence of hepatocellular carcinoma(HCC)after liver resection,and to evaluate the value of ALBI score in predicting early recurrence of HCC after liver resection.Methods Clinical data of patients diagnosed with HCC combined with hepatectomy in the Department of Hepatopancreatobiliary Surgery,The First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were retrospectively collected and divided into two groups according to whether they had recurrence within 2 years after surgery:early recurrence group(n=63,recurrence within 2 years)and no early recurrence group(n=75,no recurrence within 2 years).The risk factors of early recurrence were analyzed.Kaplan-Meier method and Log-Rank test were used to compare the tumor-free survival rate of patients with different ALBI scores.Results There were significant differences in maximum tumor diameter,microvascular invasion,alkaline phosphatase,alpha-fetoprotein and ALBI scores between early recurrence group and non-early recurrence group(P<0.05).Multivariate Logistic regression analysis showed tumor diameter(OR=2.201,95%CI 1.055-4.594,P=0.036),MVI(OR=2.425,95% CI 1.058-5.562,P=0.036)and ALBI grade(OR=2.442,95% CI 1.130-5.279,P=0.023)are independent risk factors for early recurrence after HCC resection.There were differences in recurrence at 6 months,1 year and 2 years after resection in different ALBI groups(P<0.05).Kaplan-Meier recurrence-free high-grade ALBI group was higher than that in lowgrade ALBI group,and the difference was statistically significant(P<0.05).Conclusion ALBI score has a certain value in predicting early recurrence after HCC resection,and can be used for risk stratification of postoperative recurrence in HCC patients.
作者
凌帅波
李路豪
刘兆臣
李素新
李林
刘胜炎
党晓卫
LING Shuai-bo;LI Lu-hao;LIU Zhao-chen;DANG Xiao-wei(Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Key Laboratory of Precision Diagnosis and Treatment in General Surgical(Hepatobiliary and Pan-creatic)Diseases of Health Commission of Henan Province,Henan Province Engineering Research Center of Minimally Inva-sive Diagnosis and Treatment of Hepatobiliary and Pancreatic Diseases,Zhengzhou 450052,China)
出处
《中国实用外科杂志》
CAS
CSCD
北大核心
2023年第12期1407-1412,共6页
Chinese Journal of Practical Surgery
基金
河南省高等学校重点科研项目(No.21A320062)。
