首页|术前红细胞分布宽度与肝细胞癌患者TACE治疗预后的相关性分析

术前红细胞分布宽度与肝细胞癌患者TACE治疗预后的相关性分析

Correlation analysis of preoperative red blood cell distribution width and prognosis of patients under-going TACE for hepatocellular carcinoma

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目的 评估红细胞分布宽度(RDW)与经导管肝动脉化疗栓塞(TACE)治疗的肝细胞癌患者预后的关系.方法 回顾性分析2011年1月至2018年5月徐州医科大学附属医院介入放射科连续收治的首次TACE治疗的212例肝细胞癌患者临床资料,其中男性184例,女性28例,年龄(56.8±11.2)岁.随访生存情况.应用X-tile软件确定13.1%作为术前RDW预测预后的最佳界值,并据此将入组患者分为低水平组(RDW<13.1%,n=70)和高水平组(RDW≥13.1%,n=142).比较两组天冬氨酸氨基转移酶、总胆红素、白蛋白、血红蛋白及脂蛋白a、巴塞罗那临床肝癌(BCLC)分期等指标.采用Kaplan-Meier法进行生存分析,log-rank检验比较生存率,Cox回归分析RDW对患者预后的影响.结果 RDW高水平组术后1、2、3年累积生存率分别为34.5%、14.1%、6.3%,低水平组分别为64.3%、38.6%、21.4%,差异有统计学意义(x2=23.09,P<0.001).高水平组与低水平组比较,天冬氨酸氨基转移酶、总胆红素水平较高,白蛋白、血红蛋白及脂蛋白a水平较低,门静脉癌栓比例更高,BCLC分期更晚,差异均有统计学意义(均P<0.05).Cox回归分析显示,RDW≥13.1%(HR=1.732,95%CI:1.223~2.452,P=0.002)的肝细胞癌患者TACE术后生存预后差.结论 术前RDW≥13.1%是肝细胞癌患者TACE术后生存的独立危险因素,RDW是有潜能的预测肝细胞癌患者预后的指标.
Objective To evaluate the relationship between red blood cell distribution width(RDW)and prognosis of patients with hepatocellular carcinoma(HCC)andergoing transcatheter arterial chemoembolization(TACE).Methods Clinical data of 212 patients with HCC andergoing TACE for the first time in Department of Interventional Radiology,the Affiliated Hospital of Xuzhou Medical University from January 2011 to May 2018 were retrospectively analyzed,including 184 males and 28 females,aged(56.8±11.2)years.Follow-up for survival.X-tile software was used to determine 13.1%as the optimal threshold for preoperative RDW prediction of prognosis,and enrolled patients were divided into a low level group(RDW<13.1%,n=70)and a high level group(RDW≥ 13.1%,n=142).Aspartate aminotrans-ferase,total bilirubin,albumin,hemoglobin and lipoprotein a,Barcelona clinical liver cancer(BCLC)stage and other indexes were compared between the two groups.Survival analysis was performed by Kaplan-Meier method,survival rate was compared by log-rank test,and the effect of RDW on prognosis was analyzed by Cox regression.Results The 1-year,2-year and 3-year cumulative survival rates in RDW high level group were 34.5%,14.1%and 6.3%,respectively,while those in RDW low level group were 64.3%,38.6%and 21.4%,respectively,with significant difference(x2=23.09,P<0.001).Compared with the low level group,the levels of aspartate aminotransferase and total bilirubin were higher,the levels of albu-min,hemoglobin and lipoprotein a were lower,the proportion of portal vein cancer thrombin was higher,and the stage of BCLC was later,with statistical significance(all P<0.05).Cox regression analysis showed that HCC patients with RDW≥13.1%(HR=1.732,95%CI:1.223-2.452,P=0.002)had poor survival prognosis after TACE.Conclusion Preoperative RDW≥13.1%is an independent risk factor for survival after TACE in patients with HCC.RDW has potential predictive value for prognosis of patients with HCC.

Carcinoma,hepatocellularChemoembolization,therapeuticPrognosisRed blood cell distribution width

应廷嵩、范志祥、徐浩、刘旺、王汝鉴、张庆桥、魏宁、崔艳峰、刘洪涛

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徐州医科大学附属医院介入放射科,徐州 221006

癌,肝细胞 化学栓塞,治疗性 预后 红细胞分布宽度

2024

中华肝胆外科杂志
中华医学会

中华肝胆外科杂志

CSTPCD北大核心
影响因子:1.846
ISSN:1007-8118
年,卷(期):2024.30(3)
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