术前Fib-4指数对肝癌肝切除术后复发的预测价值

目的评价肝癌患者术前Fib-4指数对肝癌肝切除术后复发的预测价值。方法回顾性分析67例行肝部分切除肝癌患者的临床资料，根据患者术前Fib-4指数的大小分为低指数组（Fib-4指数〈3．25）和高指数组（Fib-4指数≥3．25），术后应用门诊、电话方式随访，以Cox回归模型对术后复发情况进行相关因素分析。结果单因素分析提示，术前AFP≥400μg／L、肿瘤最大直径〉5cm、肿瘤数目〉3个、Fib-4指数I〉3．25、血管侵犯及切缘阳性、门静脉癌栓是影响肝癌肝切除术后无瘤生存的危险因素（P均〈0．05），Cox回归分析显示术前Fib-4指数≥3．25、肿瘤数目〉3个及门静脉癌栓是肝癌术后复发的独立危险因素（P均〈0．05）。结论术前Fib-4指数≥3．25是影响肝癌患者术后复发的独立危险因素。

Predictive value of preoperative Fib-4 index on postoperative recurrence of hepatocellular carcinoma after hepatectomy

Objective To investigate the postoperative recurrence predictive value of preoperative Fib-4 index on hep- atocellular carcinoma patients. Methods Clinical data of 67 cases of hepatoeellular carcinoma underwent hepatectomy in the 5th Hospital Affiliated to Sun Yat-sen University were analyzed retrospectively. According to the preoperative Fib-4 in- dex, these patients were divided into 2 groups, one was Fib-4 index 〈3.25, the other was Fib-4 index≥3.25. These pa- tients were follow-up visited by using outpatient service and telephone till 2013 September. Cox ratio risk pattern analysis was used for the recurrent correlative factors. Results Univariate analysis showed that preoperative AFP≥400 ug/L, the maximum diameter of the tumor 〉 5cm, the number of tumor 〉 3, Fib-4 index ≥ 3.25, vascular invasion, positive resection margin and portal vein tumor thrombus were all risk factors of poor disease-free survival （ all P 〈 0.05 ）. Cox regression a- nalysis revealed that Fib-4 index≥3.25, the number of tumor 〉 3 and portal vein tumor thrombus were independent predic- tors of poor disease-free survival after hepateetomy for hepatocellular carcinoma （ all P 〈 0.05 ）. Conclusion Preoperative Fib-4 index≥3.25 is an independent risk factor for predicting the postoperative recurrence of patients with hepatocellular carcinoma.