术前FIB-4评分与肝细胞癌术后患者预后的关系研究

罗晓勇; 杜成友; 阎雄; 李德卫; 李明; 吴乔; 廖锐

doi:10.3969/j.issn.1000-8179.2017.10.185

术前FIB-4评分与肝细胞癌术后患者预后的关系研究

doi: 10.3969/j.issn.1000-8179.2017.10.185

罗晓勇^{①, ②,},
杜成友^②,
阎雄^②,
李德卫^②,
李明^②,
吴乔^②,
廖锐^②, ,

①.
重庆市九龙坡区人民医院普外科（重庆市400050）
②.
重庆医科大学附属第一医院肝胆外科

基金项目:

国家临床重点专科建设项目 2012-649

国家自然科学基金 81301656

详细信息

作者简介:
罗晓勇专业方向为肝胆、胃肠肿瘤的诊治。E-mail：dekongkong@126.com

通讯作者:
廖锐 liaorui99@163.com

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出版历程
- 收稿日期: 2017-02-17
- 修回日期: 2017-05-02
- 刊出日期: 2017-05-30

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

LUO Xiaoyong^{①, ②
,},
DU Chengyou^②,
YAN Xiong^②,
LI Dewei^②,
LI Ming^②,
WU Qiao^②,
LIAO Rui^{②
, ,}

①.
Department of General Surgery, Chongqing Jiulongpo People's Hospital, Chongqing 400050, China
②.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University Chongqing, 400010, China

Funds:

the National Key Clinical Specialist Construction Programs of China 2012-649

the National Natural Science Foundation of China 81301656

More Information

Corresponding author: Rui LIAO; E-mail: liaorui99@163.com

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。
- 肝细胞癌 /
- 肝硬化 /
- FIB-4 /
- 乙型病毒性肝炎 /
- 预后
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.
- hepatocellular carcinoma /
- liver cirrhosis /
- FIB-4 /
- hepatitis B virus /
- prognosis

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图 1 肝细胞癌患者的生存曲线

Figure 1. Overall survival (A) and recurrence-free survival (B) curves of patients with hepatocellular carcinoma

A. OS; B. RFS

下载: 全尺寸图片幻灯片

表 1 肝细胞癌患者的临床病理特征

Table 1. Clinical characteristics of patients with hepatocellular carcinoma

表 2 患者总生存时间和无瘤生存时间的单因素和多因素分析

Table 2. Univariate and multivariate analyses for the overall and recurrence free survival of patients

表 3 高FIB-4评分组（ > 3.25，n=69）的预后分析

Table 3. Prognostic analyses of high FIB-4 scoring subgroup ( > 3.25, n=69)

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