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肝细胞癌治疗切除后肝外复发的术前和术后预测因素
Chang Hun Lee1, Yun Chae Lee1, Seung Young Seo1
1Department of Internal Medicine, Jeonbuk National University Medical School and Research Institute of Clinical Medicine of Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Korea.
BMC cancer
|August 24, 2025
概括
这项研究确定了肝癌手术后肝外复发的关键因素. 开发的模型 (EHR-preop和EHR-postop) 有助于识别高风险患者进行个性化治疗.
科学领域:
- 肝胆外科手术
- 外科瘤学
- 胃肠病学
背景情况:
- 在肝细胞癌 (HCC) 切除后,肝外复发 (EHR) 是一个重大问题.
- 在治愈性HCC切除后,EHR的预测因素仍未得到充分研究.
- 这项研究调查了影响EHR的术前和术后因素,持续了十年.
研究的目的:
- 在治愈性肝细胞癌 (HCC) 切除后确定和验证肝外复发 (EHR) 的预测模型.
- 为了提高临床决策能力,将患者分为风险组.
- 提升对HCC患者的个性化治疗.
主要方法:
- 之前未接受治疗的1069名接受治疗切除的HCC患者的回顾性分析 (2004 - 2019年).
- 分为导出 (n=683) 和验证 (n=386) 的队列.
- 用于开发和验证EHR预备和EHR后期模型的多变量Cox回归和Kaplan-Meier分析.
主要成果:
- 在15. 7%的患者中出现EHR.
- 术前预测因素包括年轻年龄,晚期瘤,超过米兰标准,ALBI等级≥2.
- 术后预测因素包括年龄,瘤数量,微血管侵袭,死亡,超过米兰标准,ALBI等级≥2.
- 开发的EHR预备和EHR后期模型在导出和验证队列中显示出明显的风险分层.
结论:
- 经过验证的EHR预期和EHR后期模型有效预测HCC切除后的肝外复发风险.
- 这些模型可以帮助临床医生识别高风险患者.
- 通过风险分层的患者选择,可以改善个性化HCC管理.
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