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不同肝功能Child-Pugh分级对肝癌肝移植受者预后的影响

林国桢 代天星 刘荣强 邓铭彬 汪国营 易述红 李华 杨扬 陈规划

林国桢, 代天星, 刘荣强, 等. 不同肝功能Child-Pugh分级对肝癌肝移植受者预后的影响[J]. 器官移植, 2019, 10(3): 308-312. doi: 10.3969/j.issn.1674-7445.2019.03.014
引用本文: 林国桢, 代天星, 刘荣强, 等. 不同肝功能Child-Pugh分级对肝癌肝移植受者预后的影响[J]. 器官移植, 2019, 10(3): 308-312. doi: 10.3969/j.issn.1674-7445.2019.03.014
Lin Guozhen, Dai Tianxing, Liu Rongqiang, et al. Effect of different liver function Child-Pugh classification on clinical prognosis of hepatocellular carcinoma recipients after liver transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(3): 308-312. doi: 10.3969/j.issn.1674-7445.2019.03.014
Citation: Lin Guozhen, Dai Tianxing, Liu Rongqiang, et al. Effect of different liver function Child-Pugh classification on clinical prognosis of hepatocellular carcinoma recipients after liver transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(3): 308-312. doi: 10.3969/j.issn.1674-7445.2019.03.014

不同肝功能Child-Pugh分级对肝癌肝移植受者预后的影响

doi: 10.3969/j.issn.1674-7445.2019.03.014
基金项目: 

国家自然科学基金 81870449

国家自然科学基金 81770648

国家自然科学基金 81670601

十三五科技重大专项 2017ZX10203205-006-001

广州市科技计划项目 2014Y2-00544

广州市科技计划项目 2014Y2-00200

广东省科技计划项目 2017B020209004

广州市健康医疗协同创新项目 201604020001

详细信息
    作者简介:

    林国桢,男,1992年生,硕士研究生,研究方向为肝癌、肝移植,Email:linguozhen8@qq.com

    通讯作者:

    汪国营,男,1978年生,博士,主任医师,博士研究生导师,研究方向为肝癌、肝移植,Email: wanggy3@126.com

  • 中图分类号: R617, R735.7

Effect of different liver function Child-Pugh classification on clinical prognosis of hepatocellular carcinoma recipients after liver transplantation

More Information
  • 摘要:   目的  探讨不同Child-Pugh分级对肝细胞癌(肝癌)肝移植受者术后肝癌复发和生存的影响。  方法  回顾性分析125例接受肝移植的肝癌受者临床资料,用Kaplan-Meier方法计算肝癌肝移植受者术后3年的无瘤生存率(DFS)和总生存率(OS)。采用Cox比例风险回归模型分析可能影响肝癌肝移植受者术后复发及生存的独立危险因素。  结果  中位随访时间为25.6个月,3年总的DFS和OS分别为68.4%和65.7%。Child-Pugh A、B级肝癌患者(113例)的3年DFS和OS分别是68.6%和66.2%,Child-Pugh C级肝癌患者(12例)的3年DFS和OS分别是66.7%和65.6%,两者差异均无统计学意义(均为P>0.05)。Cox回归分析结果表明,血管侵犯(P=0.001)和肿瘤数目>3个(P=0.025)是影响肝癌肝移植受者复发的独立危险因素。甲胎蛋白(AFP)> 400 μg/L(P=0.035)、血管侵犯(P=0.031)和肿瘤数目>3个(P=0.008)是影响肝癌患者生存的独立危险因素。  结论  Child-Pugh C级与A、B级肝癌患者肝移植术后预后无显著性差异,AFP、血管侵犯和肿瘤数目是影响肝癌患者肝移植术后预后的重要因素,肝移植可作为Child-Pugh C级肝癌患者的有效治疗手段。

     

  • 图  1  肝功能Child-Pugh分级与肝癌肝移植受者DFS和OS的相关性

    Figure  1.  Correlation between Child-Pugh classification of liver function and DFS, OS in hepatocellular carcinoma recipients after liver transplantation

    表  1  125例肝癌肝移植受者临床病理特征与预后多因素Cox回归分析结果

    Table  1.   Results of multivariate Cox regression analysis of clinicopathological features and prognosis in 125 hepatocellular carcinoma recipients after liver transplantation

    影响因素 3年DFS 3年OS
    相对危险度 95%置信区间 P 相对危险度 95%置信区间 P
    Child-Pugh分级(A、B级/C级) 0.574 0.114
    血管侵犯(有/否) 3.106 1.565~6.165 0.001 2.300 1.080~4.899 0.031
    肿瘤数目(≤3个/ > 3个) 2.292 1.107~4.744 0.025 3.148 1.352~7.331 0.008
    AFP(≤400 μg/L或 > 400 μg/L) 0.147 2.168 1.056~4.451 0.035
    肿瘤直径(≤4 cm/ > 4 cm) 0.126 0.168
    Milan标准(是/否) 0.895 0.325
      –为无数据
    下载: 导出CSV
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出版历程
  • 收稿日期:  2019-01-25
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2019-05-15

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