术前FIB-4评分与肝细胞癌术后患者预后的关系研究

Relationship between preoperative FIB-4 and hepatocellular carcinoma prognosis after curative resection

    摘要
  • 摘要:
      目的   探讨FIB（Fibrosis）-4评分系统与肝细胞癌（HCC）患者临床病理特征及预后的关系。
      方法   收集2009年1月至2012年12月间245例接受根治性肝切除手术的HCC患者的临床及随访资料进行分析，利用Kaplan-Meier进行单因素生存分析，Cox比例风险回归模型进行多因素生存分析。
      结果   根据患者术前FIB-4评分，将患者分为FIB-4Ⅰ（≤3.25）和FIB-4Ⅱ（ > 3.25）。FIB-4能够预测肝硬化程度（Ishak分级：1~5级 vs. 6级，r=0.681，P < 0.001），其主要与患者的肝功能指标如谷草转氨酶（P < 0.001）、胆红素（P=0.009）、白蛋白（P=0.001）及血小板计数（P < 0.001）相关，与其他病理特征无关。单因素及多因素分析均表明FIB-4能够预测HCC患者的预后（总生存时间：P=0.037，0.011；无瘤生存时间：P=0.027，0.043）。
      结论  FIB-4有可能作为HCC根治性切除术后的预后参考指标之一。

     

    Abstract:
      Objective  To investigate the correlation between FIB-4 and the clinicopathological characteristics and prognosis of patients with hepatocellular carcinoma (HCC) after curative resection.
      Methods   From January 2009 to December 2012, the clinicopathological and follow-up data of 245 patients with HCC after curative resection were retrospectively studied. Their survival was calculated using the Kaplan-Meier method. The Cox proportional hazard regression model was used for the multivariate analysis.
      Results   According to FIB-4 index, patients were divided into two subgroups: FIB-4Ⅰ(≤3.25) and FIB-4Ⅱ( > 3.25). FIB-4 could predict liver cirrhosis severity (Ishak grade, Grade 1-5 vs. Grad 6, r=0.681, P < 0.001). It was associated with liver function such as:aspartate transaminase (P < 0.001)、total bilirubin (P=0.009)、albumin (P=0.001) and platelet count (P < 0.001) other than tumor clinicopathologic features. Both univariate and multivariate analysis showed FIB-4 could predict the prognosis of HCC patients (Overall survival: P=0.037 and 0.011; Recurrencefree survival: P=0.027 and P=0.043, respectively).
      Conclusion   The preoperative FIB-4 index could be used as a prognostic marker for the prognosis of HCC after curative hepatectomy.

     

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