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J Gastroenterol Hepatol:肝细胞癌监测失败的发生率和危险因素

2018-08-27 MedSci MedSci原创

在被纳入监测计划的患者中,大约25%的HCC病例超出了米兰标准。诊断时Child-Pugh B/C和AFP≥100 ng/mL与肿瘤监测失败相关。然而,在入组,肝脏功能储备处于Child-Pugh B级,以及在随访期间出现与肝脏相关的并发症可能是早期肝癌监测失败的预测因素。

研究背景和目的:肝细胞癌(HCC)监测旨在早期发现肿瘤以提高生存率。这项研究的目的是评估肝癌监测失败发生的频率和危险因素。

研究方法:该研究分析了188例被诊断为HCC的患者的数据,这些患者接受了一项对1242例肝硬化患者进行的监测,即采用超声和检测甲胎蛋白(AFP)水平,每3或6个月进行一次。肝癌监测失败被定义为HCC超过米兰标准。分析入组时、随访时和HCC诊断时记录的变量。

研究结果:在诊断中,50(26.6%)例患者的HCC肿瘤超出了米兰标准。在单变量分析中,入组时肝脏功能储备处于Child-Pugh B (P = 0.03),在肿瘤诊断前发生门静脉高压(P = 0.03), 未能完成前一轮筛选(P = 0.02), 肝脏功能储备处于Child-Pugh B/C (P = 0.001) (P = 0.001)和甲胎蛋白≥100 ng / mL(P = 0.03)等因素与肝癌监测失败有关。多元分析表明,在诊断时,仅Child-Pugh B/C(危险比,3.18;95%可信区间,1.66-6.10,P < 0.001)和AFP≥100 ng/mL(危险比,2.80;95%置信区间1.37-5.71,P = 0.005)与肝癌监测失败独立相关。肿瘤在米兰标准范围内的患者的生存率高于肿瘤监测失败患者(33.9 vs 7.6个月,P < 0.001)的生存率。

研究结论:在被纳入监测计划的患者中,大约25%的HCC病例超出了米兰标准。诊断时Child-Pugh B/C和AFP≥100 ng/mL与肿瘤监测失败相关。然而,在入组,肝脏功能储备处于Child-Pugh B级,以及在随访期间出现与肝脏相关的并发症可能是早期肝癌监测失败的预测因素。

原始出处

Mancebo A, Varela M, Gonzalez-Dieguez ML, et al. Incidence and risk factors associated with hepatocellular carcinoma surveillance failure. J Gastroenterol Hepatol, 2018, 33(8), 1524-1529.

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    2018-11-09 xjy02
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    2018-08-29 gwc384
  8. [GetPortalCommentsPageByObjectIdResponse(id=2072255, encodeId=c5a320e2255a7, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Jun 23 16:20:00 CST 2019, time=2019-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826470, encodeId=5ca218264e0df, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Sun Feb 17 10:20:00 CST 2019, time=2019-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064457, encodeId=2002206445eb5, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Jun 27 19:20:00 CST 2019, time=2019-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711603, encodeId=6a891e1160328, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Jul 14 22:20:00 CST 2019, time=2019-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978732, encodeId=74d119e8732a0, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Mon Jul 01 03:20:00 CST 2019, time=2019-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863386, encodeId=62d518633861d, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Fri Nov 09 00:20:00 CST 2018, time=2018-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427203, encodeId=7235142e2039d, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed Aug 29 09:20:00 CST 2018, time=2018-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341348, encodeId=b31b3413484b, content=学习了,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Mon Aug 27 21:24:26 CST 2018, time=2018-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=341336, encodeId=6afb34133621, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Aug 27 18:36:35 CST 2018, time=2018-08-27, status=1, ipAttribution=)]
    2018-08-27 王秀

    学习了,涨知识了!

    0

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    2018-08-27 1ddf0692m34(暂无匿称)

    学习了,谢谢分享

    0

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