摘要
目的:评价不同分期系统对晚期肝癌预后的预测价值,为晚期肝癌临床预后分组标准的建立提供一定的理论依据。方法:使用1989年Child-Pugh评分、2002年TNM分期和进展期肝癌预后系统(ALCPS)在诊断时对169例进展期肝癌患者进行评分,并随访。通过Kaplan-Meier、接受者工作特征曲线(ROC)及Logistic等方法评价不同评分系统对3个月生存率及总生存的预测价值。结果:Kaplan-Meier曲线提示ALCPS各曲线无效,有良好区分价值。Logistic回归及ROC曲线发现,ALCPS对于不经任何抗肿瘤治疗的晚期肝癌患者3个月生存率的预测价值最大,曲线下面积高达0.85,以14分左右预测切点,具有81.82%(72/88)的敏感性及79.01%(64/81)的特异性,P=0.000 1。结论:ALCPS是预测晚期肝癌3个月生存率的良好评分系统,可为晚期肝癌临床预后分组提供参考。
OBJECTIVE： To evaluate current prognostic score systems in predicting prognosis of patients with advanced hepatocellular carcinoma （HCC） ,and stratify the prognosis of these patients. METHODS： A total of 169 advanced HCC patients were included. Data were collected to classify patients according to TNM Stage, Advanced Liver Cancer Prognostic System （ALCPS） and Child-Pugh Score （1989）. The patients enrolled were followed up until the date of death or when censored at the latest date. Overall survival and 3-month mortality were the end points used in this analysis. Survival analysis,Cox regression, relative operating characteristic （ROC）, and logistic regression were utilized to access the prognostic value of the score systems. RESULTS： ALCPS presented well discriminary ability for prognosis in KaplanMeier analysis. And logistic regression and ROC analysis confirmed that ALCPS was the best prognostic system for 3-month Survival. Its area under curve was as high as 0.85. The cut-off point for ALCPS was 14 with sensitivity of 81.82 % （72/88） and specificity of 79.01 % （64/81, P=0. 000 1）. CONCLUSION： ALCPS is good score system in prediction of 3-month mortality among the current systems analyzed, and ALCPS might be proper prognostci criteria for advanced HCC.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第7期485-488,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
广东省科技计划(2009B060700024
2011B031800076)
关键词
肝癌
晚期
生存
评分系统
hepatocellular carcinoma
mortality survival
clinical trial
