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合并微血管侵犯的肝癌肝移植受者的预后评价

梁梓明 叶林森 唐晖 宋来恩 顾世杰 易述红

梁梓明, 叶林森, 唐晖, 等. 合并微血管侵犯的肝癌肝移植受者的预后评价[J]. 器官移植, 2020, 11(3): 350-355. doi: 10.3969/j.issn.1674-7445.2020.03.005
引用本文: 梁梓明, 叶林森, 唐晖, 等. 合并微血管侵犯的肝癌肝移植受者的预后评价[J]. 器官移植, 2020, 11(3): 350-355. doi: 10.3969/j.issn.1674-7445.2020.03.005
Liang Ziming, Ye Linsen, Tang Hui, et al. Evaluation of clinical prognosis of liver transplant recipients of hepatocellular carcinoma complicated with microvascular invasion[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 350-355. doi: 10.3969/j.issn.1674-7445.2020.03.005
Citation: Liang Ziming, Ye Linsen, Tang Hui, et al. Evaluation of clinical prognosis of liver transplant recipients of hepatocellular carcinoma complicated with microvascular invasion[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 350-355. doi: 10.3969/j.issn.1674-7445.2020.03.005

合并微血管侵犯的肝癌肝移植受者的预后评价

doi: 10.3969/j.issn.1674-7445.2020.03.005
基金项目: 

国家自然科学基金 81600505

广东省自然科学基金 2016A030313224

中国博士后科学基金资助项目 2019TQ0369

详细信息
    作者简介:

    梁梓明,男,1993年生,硕士研究生,研究方向为肝移植、肝癌,Email:liangzim@163.com

    通讯作者:

    易述红,男,1973年生,博士,主任医师,博士研究生导师,研究方向为肝移植、肝癌,Email:yishuhong@163.com

  • 中图分类号: R617

Evaluation of clinical prognosis of liver transplant recipients of hepatocellular carcinoma complicated with microvascular invasion

More Information
  • 摘要:   目的  探讨合并微血管侵犯(MVI)的肝细胞癌(肝癌)肝移植受者的预后情况。  方法  通过美国国立癌症研究所的监测、流行病学和最终结果(SEER)数据库提取行肝移植术的3 447例肝癌受者的临床资料。根据受者有否MVI分为MVI组(376例)和无MVI组(3 071例)。分析比较两组肝移植受者的预后情况,包括术后1、3、5年总生存率(OS)及肝癌特异生存率(LCSS)。纳入两组受者的相关临床资料,包括年龄、性别、人种、病理分化、肿瘤大小、淋巴结转移、远处转移、肿瘤-淋巴结-转移(TNM)分期、MVI,采用多因素Cox模型分析肝癌肝移植受者预后的独立危险因素。绘制预测受者预后的列线图,通过一致性指数评价模型准确度。  结果  无MVI组受者术后1、3、5年OS和LCSS分别为93.5%、82.1%、75.3%和98.3%、93.8%、90.7%,明显高于MVI组的88.8%、72.1%、68.4%和95.3%、83.1%、80.4%(均为P < 0.05)。多因素回归分析显示病理分化、肿瘤大小、淋巴结转移、远处转移、TNM分期以及MVI均是影响肝癌肝移植受者OS与LCSS的独立危险因素(均为P < 0.05)。列线图一致性指数为0.624(0.602~0.648)。  结论  MVI是肝癌肝移植受者预后的独立危险因素,与受者预后不良显著相关,以此为基础构建的列线图可预测患者预后情况。

     

  • 图  1  两组肝癌肝移植受者的生存曲线

    Figure  1.  Survival curves of liver transplant recipients of hepatocellular carcinoma in two groups

    图  2  预测肝癌肝移植受者预后的列线图

    Figure  2.  Nomogram for predicting the prognosis of liver transplant recipients of hepatocellular carcinoma

    表  1  影响肝癌肝移植受者OS及LCSS的危险因素分析

    Table  1.   Analysis of risk factors affecting OS and LCSS in liver transplant recipients of hepatocellular carcinoma

    参数 OS LCSS
    HR(95% CI P HR(95% CI P
    年龄 0.887(0.767~1.027) > 0.05 0.873(0.656~1.188) > 0.05
    性别 0.876(0.755~1.016) > 0.05 1.016(0.766~1.348) > 0.05
    人种 0.986(0.902~1.077) > 0.05 1.057(0.669~1.668) > 0.05
    AFP 1.168(1.012~1.348) > 0.05 0.900(0.669~1.211) > 0.05
    病理分化 1.701(1.413~2.049) < 0.05 2.940(2.203~3.924) < 0.05
    肿瘤大小 1.063(0.991~1.141) < 0.05 1.284(0.918~1.795) < 0.05
    淋巴结转移 1.534(1.026~2.016) < 0.05 1.716(1.213~3.165) < 0.05
    远处转移 1.590(1.042~2.205) < 0.05 1.793(1.301~3.241) < 0.05
    TNM分期 1.735(1.282~2.348) < 0.05 3.050(1.979~4.701) < 0.05
    MVI 1.388(1.154~1.669) < 0.05 2.098(1.580~2.785) < 0.05
    注:①HR为风险比。
    CI为可信区间。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-01-30
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-05-15

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