肝癌分化程度与临床因素的关系探究

目的：研究与肝癌分化程度不良相关的临床危险因素。方法：回顾性分析74例行肝癌根治性切除术的患者，提取术前人口统计学资料、实验室检验资料、常规超声及超声造影诊断资料，分析其与不同肝癌分化程度之间的关系。结果：74例患者分为高分化组（41例）和中-低分化组（33例），两组患者的年龄、性别差异无统计学意义。单因素分析结果显示两组患者在血清总胆红素（TBIL）≥20μmol/L、血清甲胎蛋白（AFP）≥400 ng/ mL （P=0.004）、凝血酶原时间（PT）≥14 s、超声造影“快出”增强模式（P=0.017）的差异具有统计学意义。多因素分析结果显示血清 TBIL ≥20μmol/L、血清 AFP ≥400 ng/ mL、PT ≥14 s、超声造影“快出”增强模式具有统计学意义，提示以上指标是 HCC 分化程度下降的独立危险因素。结论：血清 AFP ≥400 ng/ mL、超声造影“快出”增强模式、血清 TBIL ≥20μmol/L 以及 PT ≥14 s 是 HCC 分化程度不良的独立危险因素。这些信息可能帮助临床医生更好地制定围术期的肿瘤综合诊疗方案。

Relationship between differentiation of hepatocellular carcinoma and clinical factors

Objective To study the clinical risk factors associated with poor differentiation of hepatocellular carcinoma(HCC). Methods A retrospective analysis was performed on 74 patients who underwent surrgical resection for HCC, and patients’demographic data, laboratory exa mination data, conventional ultrasound and CEUS diagnostic data were ana-lyzed to deter mine their relationship with the differentiation of hepatocellular carcinoma. Results 74 patients were divided into the high differentiation group (41 cases) and the moderate-poor differentiation group (33 cases). There were no significant differences in age and sex between two groups . Univariate analysis showed that the differences of serumα-fetal protein (AFP)≥ 400 ng/ mL , serum bilirubin (TBIL) ≥20 μmol/L , prothrombin time (PT) ≥14 s,“fast wash-out”enhancement pattern between two groups were statistically significant. Logistic regression analysis showed serum TBIL ≥20 μmol/L , serum AFP ≥400 ng/ mL, PT ≥14 s,“fast wash-out”enhancement pattern were independent risk factors for the poor differentiation of HCC. Conclusion serum AFP ≥ 400 ng/ mL, serum TBIL ≥20 μmol/L, PT ≥14 s, and“fast wash-out”enhancement pattern are independent risk factors for the poor differentiation of HCC. The finding can provide beneficial information for HCCs manage-ment process.