摘要
肝癌是全球范围内危害极大的恶性肿瘤,乙肝病毒慢性感染是我国肝癌发生的主要病因,而肝硬化是肝癌不良预后的独立危险因素,但仍有部分乙肝相关肝癌患者肝脏不发生硬化,肝硬化和非肝硬化乙肝相关肝癌患者的临床及病理差异尚不明。对比分析两组病人的临床病理差异,旨在为乙肝相关肝癌的个性化临床诊治提供一定的数据支撑。对941例行根治性肝切除手术的肝癌患者进行筛选后得到乙肝阳性肝癌患者731例,其中肝硬化病人584例(79.9%),非肝硬化病人147例(20.1%),进一步通过软件分析两组病例的临床及病理差异。结果表明:肝硬化组病人男性比例(89.7%vs.78.9%)、年龄(51.6±11.8 vs.47.4±11.7岁)、ALP值(98.0 vs.89.5 U/L)、ALT值(43.0 vs.36.0 U/L)、TBIL值(15.3 vs.14.1μmol/L)均比非肝硬化组病人高(P<0.05),但肝硬化组病人的ALB值(41.1 vs.42.1 g/L)、PLT值(171.0 vs.214.0×10~9/L)比非肝硬化组病人低(P<0.01);两组病人腹水人数(19.0%vs.9.5%)、TNM Ⅰ及Ⅱ人数(27.1%vs.40.1%,37.2%vs.23.8%)、肿瘤有包膜人数(13.4%vs.23.8%)、单发病灶人数(73.8%vs.85.0%)及两个病灶人数(13.8%vs.6.1%)均有显著性差异(P<0.05);大部分乙肝阳性肝癌病人临床表现为肝硬化,单发病灶患者占多数;相比较于非肝硬化病人,肝硬化病人男性比例更高,肝功能更差,两发病灶更多,包膜肿瘤更少,腹水人数更多。
Hepatocellular carcinoma(HCC) is one of the most harmful malignant tumor worldwide, chronic hepatitis B virus(HBV) infection is the main cause of HCC in China, and liver cirrhosis is an independent risk factor for poor prognosis of HCC. However, some patients with hepatitis B-related liver cancer do not develop cirrhosis, and the clinical and pathological differences between patients with cirrhosis and non-cirrhosis B related liver cancer are still not clear. The comparative analysis of the clinicopathological differences between the two groups of patients aims to analyze the clinical and pathological differences between these two groups, and to provide data for personalized clinical diagnosis and treatment for HBV-related HCC patients. In 941 HCC patients who underwent radical hepatectomy, there were total of 731 HCC patients with HBV-positive infection included in this study after exclusion screening, including 584 patients with liver cirrhosis(79.9%) and 147 patients without liver cirrhosis(20.1%), were retrospectively collected. The clinical and pathological differences between the two groups were analyzed by software and the results showed that in cirrhotic group, the male ratio(89.7% vs. 78.9%), age(51.6 ± 11.8vs. 47.4 ± 11.7 years), ALP(98.0 vs. 89.5 U/L), ALT(43.0 vs. 36.0 U/L), TBIL(15.3 vs. 14.1 μmol/L) were higher than that of non-cirrhotic patients(P 0.05), but the ALB value(41.1 vs. 42.1 g/L) and PLT(171.0 vs. 214.0 × 10~9/L) were lower in the former than in the latter(P 0.01). Patients with ascites(19.0% vs. 9.5%), patients in TNM Ⅰ and Ⅱ(27.1% vs. 40.1%, 37.2% vs. 23.8%), patients with tumor envelope(13.4% vs. 23.8%), patients with single lesion(73.8% vs. 85.0%) and two lesions(13.8% vs. 6.1%) had significant differences between cirrhotic and non-cirrhotic group(P0.05). The majority of HBV-positive HCC patients had liver cirrhosis and most patients were single lesion. Compared with non-cirrhotic patients, there were more male patients, worse liver function, more patients with two lesions le
作者
邓万玉
祝依蕾
陈忆琳
DENG Wanyu;ZHU Yilei;CHEN Yilin(College of Life Science,Shangrao Normal University,Shangrao Jiangxi 334001,China;The Quzhou Affiliated Hospital of W enzhou Medical University,Quzhou People's Hospital,Quzhou Zhijiang 324000,China)
出处
《上饶师范学院学报》
2023年第3期65-72,共8页
Journal of Shangrao Normal University
基金
国家自然科学基金(82260603)
江西省自然科学基金(20224BAB206005)
江西省教育厅科技研究项目(GJJ211720)。
关键词
乙肝相关肝癌
肝硬化
非肝硬化
差异
HBV-related HCC
cirrhosis
non 1-cirrhosis
diffe erences
