|本期目录/Table of Contents|

[1]王 艳,郭 志,杨雪玲,等.85例青年原发性肝癌的临床病理特征及预后因素分析[J].天津医科大学学报,2018,24(06):505-508.
　WANG Yan,GUO Zhi,YANG Xue-ling,et al.Clinicopathological features and prognosis of 85 young patients with primary hepatic carcinoma[J].Journal of Tianjin Medical University,2018,24(06):505-508.
点击复制

85例青年原发性肝癌的临床病理特征及预后因素分析(PDF)
分享到：

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24卷
期数:
2018年06期
页码:
505-508
栏目:
临床医学
出版日期:
2018-11-20

文章信息/Info

Title:
Clinicopathological features and prognosis of 85 young patients with primary hepatic carcinoma
作者:
王 艳; 郭 志; 杨雪玲; 于海鹏; 司同国; 张炜浩
（天津医科大学肿瘤医院介入科，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心，天津300060）
Author(s):
WANG Yan;  GUO Zhi;  YANG Xue-ling; YU Hai-peng;  SI Tong-guo;  ZHANG Wei-hao
（Department of Interventional Therapy，Cancer Instituteand Hospital，Tianjin Medical University， National Clinical Research Center of Cancer，Key Laboratory of CancerPrevention and Therapy of Tianjin，Tianjin’s Clinical Research Center for Cancer，Tianjin 300060，China)
关键词:
青年; 原发性肝癌; 临床病理特征; 预后
Keywords:
young patient; primary hepatic carcinoma; clinicopatholocal features;  prognosis
分类号:
R735.7
DOI:
-
文献标志码:
A
摘要:
目的：探讨青年（年龄≤40岁）原发性肝癌（PHC）患者的临床病理特征、治疗及其预后影响因素。方法：回顾分析85例青年PHC患者的临床资料，描述青年PHC患者的临床病理特征和治疗情况，并分析相关预后因素。结果：85例青年PHC患者中，男69例，女16例，男女比例4.31∶1；81.2%有肝炎病史，12.9%有肝癌家族史。52例患者有明确病理结果，其中肝细胞肝癌88.5%（46/52），胆管细胞癌7.7%（4/52），混合细胞癌3.8%（2/52）。29例患者接受手术治疗，中位总生存时间（OS）为23个月；35例接受介入治疗，中位OS为12个月；21例接受手术联合介入治疗，中位OS为33个月。单因素分析显示，肿瘤大小、肝功能Child-Pugh分级、ECOG评分、AST、ALP、总胆红素、GGT、胆碱酯酶、AFP、CEA、腹水、门脉癌栓是影响预后的相关因素（P均＜0.05）。多因素分析显示，肿瘤大小、GGT、AFP、CEA及门脉癌栓是独立预后因素（P均＜0.05）。结论：青年PHC起病隐匿，进展快，恶性度高，行手术联合介入的综合治疗可使患者生存获益，并且肿瘤大小、GGT、AFP、CEA及门脉癌栓可作为判断青年PHC患者预后的独立因素。
Abstract:
Objective: To explore clinicopatholocal features and prognostic factors for young patients with primary hepatic cancer (PHC).Methods: Eighty-five young patients with PHC were enrolled. The clinicopathological features and prognostic factors for tumor were collected. Kaplan-Meier method was adopted for survival analysis. Log-rank method and Cox regression were used for univariate and multivariate analysis. Results：Among the 85 patients, 69 were males and 16 were females. The male-to-female ratio was 4.31:1. 81.2% of the patients had a history of hepatitis, and 12.9% of the patients had a family history of liver cancer. There were 52 patients with pathological diagnosis of liver cancer, the hepatocellular carcinoma was 46 cases, 4 cases were with intrahepatic cholangiocellular carcinoma and 2 cases were with hepatocellular carcinoma and cholangiocarcinoma. The median survivals of patients who received surgery, interventionaltherapyand surgery combined interventionaltherapy were 23 months, 12 months and 33 months, respectively. Univariate analysis indicated that tumor size, Child-Pugh grading,ECOG score, total bilimbin, gamma-glutamyltransferase, serum cholinesterase,alpha fetoprotein (AFP),carcinoembryonicantigenascites(CEA) and portal venous infiltration were significant prognostic factors for survival. Multivariate analysis revealed that tumor size, gamma-glutamyltransferase, AFP, CEA and portal venous infiltration were independent prognostic factors for survival. Conclusion：Young PHC patients have high degree of malignancy, which is often followed by portal vein invasion. Patientscan benefit from the surgery combined with interventionaltherapy.The levels of AFP, CEA and GGT can be used as an independent prognostic factor for the prognosis of young patients with PHC.

参考文献/References:


[1] Lortet-Tieulent J，Soerjomataram I，Lin C C， et al. U.S. burden of cancer by race and ethnicity according to Disability-Adjusted Life years[J]. Am J Prev Med，2016，51（5）:673
[2] 陈万青，郑荣寿，张思维，等.2013年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤，2017，26（1）:1
[3] Huang H Y，Shi J F，Guo L W， et al. Expenditure and financial burden for common cancers in China: a hospital-based multicentre cross-sectional study[J]. Lancet，2016，388（1）:10
[4] 中华人民共和国卫生部.原发性肝癌诊疗规范（2011年版）[J]. 临床肝胆病杂志，2011，27（11）:1141
[5] Torre L A，Bray F，Siegel R L， et al. Global cancer statistics，2012[J].CA Cancer J Clin，2015，65（2）:87
[6] Chen C H，Chang T T，Cheng K S， et al. Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients[J].Liver Int，2006，26（7）:766
[7] 朱迎，董健，王万里，等.青年原发性肝癌的临床病理特征及肝切除术后的生存分析[J].西安交通大学学报:医学版，2014（3）:419
[8] Dhanasekaran R，Limaye A，Cabrera R. Hepatocellular carcinoma: current trends in worldwide epidemiology， risk factors， diagnosis， and therapeutics[J]. Hepat Med，2012，4:19
[9] 薛辉，雷正清，杨平华，等. 年轻人与中年人肝癌肝切除的预后比较:倾向评分匹配分析 [J]. 肝胆外科杂志， 2016，（1）:19
[10] Goh B K，Teo J Y，Chan C Y，et al. Importance of tumor size as a prognostic factor after partial liver resection for solitary hepatocellular carcinoma: Implications on the current AJCC staging system[J]. J Surg Oncol，2016，113（1）:89
[11] 芦占勇. 青年原发性肝癌的临床特征及手术治疗研究[J]. 中国卫生标准管理， 2016（11）: 29
[12] Minami Y，Yagyu Y，Murakami T， et al. Tracking navigation imaging of transcatheter arterial chemoembolization for hepatocellular carcinoma using Three-Dimensional Cone-Beam CT angiography[J]. Liver Cancer，2014，3（1）:53
[13] Li L，Tian J，Liu P，et al. Transarterial chemoembolization combination therapy vs monotherapy in unresectable hepatocellular carcinoma: a meta-analysis[J]. Tumori，2016（3）:301
[14] Jeong S O，Kim E B，Jeong S W，et al. Predictive factors for complete response and recurrence after transarterial chemoembolization in hepatocellular carcinoma[J]. Gut Liver，2017，11（3）:409
[15] An S L，Xiao T，Wang L M， et al. Prognostic significance of preoperative serum alpha-fetoprotein in hepatocellular carcinoma and correlation with clinicopathological factors: a single-center experience from China[J]. Asian Pac J Cancer Prev，2015，16（10）:4421
[16] Kamiyama T，Yokoo H，Kakisaka T，et al. Multiplication of alpha-fetoprotein and protein induced by vitamin K absence-II is a powerful predictor of prognosis and recurrence in hepatocellular carcinoma patients after a hepatectomy[J]. Hepatol Res， 2015， 45（10）:E21
[17] Sezaki H，Kobayashi M，Hosaka T，et al. Hepatocellular carcinoma in noncirrhotic young adult patients with chronic hepatitis B viral infection[J]. J Gastroenterol，2004，39（6）:550
[18] Xu X S，WanY，Song S D，et al. Model based on γ-glutamyltransferaseand alkaline phosphatasefor hepatocellular carcinoma prognosis[J]. World J Gastroenterol， 2014， 20（31）:10944

相似文献/References:

[1]韩 悦,魏殿军.miR-202、AFP及DKK1在原发性肝癌患者血清中的表达及其意义[J].天津医科大学学报,2018,24(06):517.
　HAN Yue,WEI Dian-jun.Expression and significance of miR-202, AFP and DKK1 in serum of patients with primary hepatic carcinoma[J].Journal of Tianjin Medical University,2018,24(06):517.

备注/Memo

备注/Memo:
基金项目 国家自然科学基金资助项目（81471761、81501568）
作者简介 王艳（1993-），男，硕士在读，研究方向：影像医学与核医学（介入方向）；通信作者：郭志，E-mail：cjr.guozhi@vip.163.com。
更新日期/Last Update: 2018-11-30