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肝细胞癌的LNM和MaVI的预后比较:基于多中心人口的倾向性得分匹配研究

Jinyu Zhang¹, Yifan Chen², Peng Ye³

¹Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China.

BMC gastroenterology

|August 26, 2025

概括

淋巴结转移的肝细胞癌 (HCC) 的预后可能比宏血管侵袭 (MaVI) 的肝细胞癌更好. 目前的分期系统可能无法准确地区分这些HCC亚型的预后.

科学领域:

肝胆医学肝胆医学
癌症学
外科瘤学

背景情况:

有淋巴结转移的肝细胞癌 (HCC) 不常见,预后不确定.
患有宏血管侵袭 (MaVI) 的HCC更常见,其预后更好地理解.

研究的目的:

为了比较HCC与LNM和HCC与MaVI的预后.
评估当前HCC AJCC TNM分期系统在LNM和MaVI之间预后的准确性.

主要方法:

从SEER和医院队列中对3326名HCC患者的回顾性分析.
卡普兰 - 梅尔生存分析的总生存率 (OS),癌症特异性生存率 (CSS) 和无复发生存率 (RFS).
单变量和多变量考克斯回归,以及倾向性得分匹配 (PSM) 以确定预后因素并最大限度地减少混.

主要成果:

在SEER队列中,与PSM后的MaVI患者相比,LNM患者的1年,3年和5年的OS和CSS率显著改善 (p < 0. 001).
在SEER队列中的多变量分析表明LNM有更好的OS和CSS (p < 0. 001).
在医院队列中,与MaVI患者相比,LNM患者的1年,3年和5年的生存率 (p=0. 038) 和RFS显著改善.

结论:

目前的HCC AJCC TNM分期系统可能无法准确区分LNM和MaVI患者的预后.
患有LNM的HCC可能比患有MaVI的HCC有更好的预后,特别是在接受肝切除术的患者中.
需要使用更大的数据集进行进一步的研究来证实这些发现.

关键词:

AJCC TNM 的分期肝细胞癌淋巴结转移大型血管侵袭预测情况

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