预测孤立性肝癌根治性切除患者的长期生存率

StephenW

Oncol Lett. 2018 Feb;15(2):2574-2582. doi: 10.3892/ol.2017.7612. Epub  2017 Dec 13.
Prediction of long-term survival rates in patients undergoing curative resection for solitary hepatocellular carcinoma.Cao Y1,2, Jiang Z1, Wang S1,3, Zhang H4, Jiang Y1,2,3, Lv L1,2.
Author information
1Department of Hepatobiliary Surgery, Fuzhou General Hospital (Dongfang Hospital), Fuzhou, Fujian 350025, P.R. China.2Department of Hepatobiliary Surgery Fuzong Clinical College of Fujian Medical University, Fuzhou, Fujian 350004, P.R. China.3Department of Hepatobiliary Surgery, Dongfang Hospital of Xiamen University, Fuzhou, Fujian 350025, P.R. China.4School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510000, P.R. China.

AbstractThe present study developed a novel laboratory-based algorithm to predict long-term survival rates in patients undergoing curative resection for solitary hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). The present study included 426 patients with solitary HBV-related HCC who underwent surgery for primary tumors at a single center between 2003 and 2012. Demographic characteristics, laboratory analysis, clinical pathology and immunohistochemistry of topoisomerase II-a and Ki67 were analyzed. A simple prognostic risk calculator was developed using regression coefficients from multivariate models. A prognostic risk calculator incorporating tumor encapsulation, neutrophil-to-lymphocyte ratio, vascular invasion, α-fetoprotein level, Edmondson-Steiner classification, Topo II-α, prognostic nutritional index and Child-Pugh grade was constructed. The prognostic model demonstrated good discrimination with a C-index prior to adjustment of 0.81 (95% confidence interval: 0.78-0.84) and a bootstrap-corrected C-index of 0.81. Kaplan-Meier curves demonstrated that the probabilities of overall survival rates in the low-risk group were increased compared with those in the high-risk group. The areas under the receiver operating characteristic curve using the method were greater compared with those under the 7th Tumor-Node-Metastasis system and Cancer of the Liver Italian Program scoring system [0.83 vs. 0.62 and 0.77 (P<0.001), respectively]. The simple prognostic model of the present study accurately predicted survival rates in patients. Such a prognostic risk calculator for staging patients undergoing curative resection for solitary HBV-related HCC facilitates clinical surveillance and therapy.


KEYWORDS: curative resection; hepatocellular carcinoma; neutrophil-to-lymphocyte ratio; prognostic nutritional index; topoisomerase II-α

PMID:29434976PMCID:PMC5777370DOI:10.3892/ol.2017.7612

StephenW

Oncol Lett。 2018年2月; 15（2）：2574-2582。 doi：10.3892 / ol.2017.7612。 Epub 2017年12月13日。
预测孤立性肝癌根治性切除患者的长期生存率。
曹1 1,2，姜1 1，王S1 1，3，张海4，姜1 1,2,3，吕琳1,2。
作者信息

1
    福州总医院肝胆外科（东方医院），福建福州350025，中国。
2
    福建医科大学附属福山医学院肝胆外科，福建福州350004，中国。
3
    厦门大学东方医院肝胆外科，福建福州350025，中国。
4
    中山大学公共卫生学院，广东广州510000，中国。

抽象

本研究开发了一种新的基于实验室的算法来预测接受根治性乙肝病毒（HBV）相关肝细胞癌（HCC）的根治性切除术患者的长期生存率。本研究纳入426例单纯HBV相关HCC患者，他们在2003年至2012年期间在单一中心接受原发肿瘤手术。分析拓扑异构酶II-a和Ki67的人口学特征，实验室分析，临床病理学和免疫组织化学。使用多变量模型的回归系数开发了一个简单的预后风险计算器。构建了包含肿瘤封装，嗜中性粒细胞与淋巴细胞比率，血管浸润，α-甲胎蛋白水平，Edmondson-Steiner分类，Topo II-α，预后营养指数和Child-Pugh分级的预后风险计算器。在调整0.81（95％置信区间：0.78-0.84）和自举校正C指数为0.81之前，预后模型表现出良好的C指数歧视。 Kaplan-Meier曲线表明低风险组的总生存率与高风险组相比有所增加。使用该方法的受试者工作特征曲线下面积分别高于第7肿瘤 - 淋巴结转移系统和肝意大利计划评分系统的癌症[分别为0.83对0.62和0.77（P <0.001）]。本研究的简单预后模型准确预测了患者的存活率。这种预测风险计算器用于分期接受根治性HBV相关肝癌根治性切除的患者，有助于临床监测和治疗。
关键词：

治愈性切除;肝细胞癌;嗜中性粒细胞与淋巴细胞的比例;预后营养指标;拓扑异构酶II-α

结论：
    29434976
PMCID：
    PMC5777370
DOI：
    10.3892 / ol.2017.7612

StephenW

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777370/