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体质指数对肝癌切除术后患者远期预后的影响 预览 被引量:1

Influence of body mass index on long-term prognosis of liver cancer patients after hepatectomy
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摘要 目的:评估体质指数(BMI)对肝癌切除术后患者远期预后的影响。方法:回顾性分析596例肝癌患者的临床资料,其中,肝细胞肝癌(HCC)388例,肝内胆管细胞癌(ICC)208例。根据术前BMI,将患者分为3组:BMI<18.5kg/m^2(消瘦)组、18.5kg/m^2≤BMI<25kg/m^2(体质量正常)组、BMI≥25kg/m^2(超重肥胖)组。采用Kaplan-Meier法进行预后生存分析;运用Cox比例风险回归模型进行单因素及多因素预后分析。结果:HCC与ICC患者中,消瘦组总体生存率(OS)均低于其他两组(P<0.05)。HCC患者中,消瘦组累计复发率(CRR)高于其他两组(P<0.001);ICC患者中,3组间CRR差异无统计学意义,但呈现与HCC患者相似的变化趋势。超重肥胖组与体质量正常组患者OS与CRR差异无统计学意义。BMI<18.5kg/m^2为HCC患者术后OS及CRR的独立预测指标(P<0.05)。结论:消瘦的肝癌患者术后生存率更低、复发率更高;超重或肥胖对肝癌患者术后生存及复发无明显影响。单独应用BMI预测肝癌患者术后预后情况存在局限性。 Objective:To evaluate the influence of body mass index(BMI)on the long-term prognosis of liver cancer patients after hepatectomy.Methods:Totally,596patients were enrolled with388hepatocellular carcinoma(HCC)cases and208intrahepatic cholangiocellular carcinoma(ICC)cases.Patients were divided into three groups according to the BMI:underweight group(BMI<18.5kg/m^2),normal group(18.5kg/m^2≤BMI<25kg/m^2),and overweight/obesity group(BMI≥25kg/m^2).Patients’clinical features and follow-up data were collected.Kaplan-Meier curve was applied for survival analysis,and Cox regression model was used for univariate and multivariate analysis.Results:In both HCC and ICC cases,the overall survival rate(OS)was significantly lower in the underweight group than that in the other two groups(P<0.05).In HCC cases,the cumulative recurrence rate(CRR)was higher in the underweight group(P<0.001).In ICC cases,there was no statistical difference in CRR among the three groups,but showed similar trend with HCC patients.The OS and CRR had no statistical difference between the normal and overweight/obesity groups.The multivariate analysis indicated that BMI<18.5kg/m^2was an independent prognostic factor for OS and CRR in HCC patients after surgery(P<0.05).Conclusions:Underweight patients had worse OS and higher CRR,whereas overweight and obesity might not affect the post-operative prognosis of liver cancer patients after hepatectomy.Simply using BMI has its limitation as a factor of nutrition status to evaluate the prognosis of liver cancer patients after hepatectomy.
作者 张欣 杨欣荣 周俭 ZHANG Xin;YANG Xin-rong;ZHOU Jian(Department of Liver Cancer Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
出处 《中国临床医学》 2018年第6期884-889,共6页 Chinese Journal Of Clinical Medicine
基金 国家自然科学基金(81602581).
关键词 肝癌 体质指数 预后 总体生存率 累计复发率 liver cancer body mass index prognosis overall survival rate cumulative recurrence rate
作者简介 张欣,博士,住院医师. E-mail:zhang.xin3@zs-hospital.sh.cn;通信作者:周俭. Tel:021-64037181; E-mail:zhou.jian@zs-hospital.sh.cn
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