外科理论与实践

外科理论与实践 ›› 2018, Vol. 23 ›› Issue (04): 358-362.doi: 10.16139/j.1007-9610.2018.04.017

• 论著 • 上一篇    下一篇

术前白细胞计数预测肝切除治疗超“米兰标准”肝细胞癌病人的预后

侯振宇1, 孔银龙1, 张勇强2, 朱科云1, 杨雪娇1, 陈平1, 李慧锴1, 崔云龙1, 宋天强1, 李强1, 张倜1   

  1. 1.天津医科大学肿瘤医院肝胆肿瘤科 国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室,天津 300060;
    2.天津市西青医院普通外科,天津 300380
  • 收稿日期:2018-03-21 出版日期:2018-07-25 发布日期:2020-07-25
  • 通讯作者: 张倜,E-mail: zhangti@tjmuch.com;宋天强,E-mail: tjchi@hotmail.com
  • 基金资助:
    国家自然科学基金（81672884）; 国家科技重大专项-艾滋病和病毒性肝炎等重大传染病防治（2017ZX102 03207-004-005）; 天津市科技重大专项与工程-精准医疗重大专项（15ZXJZSY00030）

Preoperative white blood cell count predicts prognosis in patients with hepatocellular carcinoma beyond Milan criteria after hepatic resection

HOU Zhenyu1, KONG Yinlong1, ZHANG Yongqiang2, ZHU Keyun1, YANG Xuejiao1, CHEN Ping1, LI Huikai1, CUI Yunlong1, SONG Tianqiang1, LI Qiang1, ZHANG Ti1   

  1. 1. Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National Cancer Clinical Research Cente, Tianjin 300060, China;
    2. Department of General Surgery, Tianjin Xiqing Hospital, Tianjin 300380, China
  • Received:2018-03-21 Online:2018-07-25 Published:2020-07-25

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摘要： 目的 探讨术前白细胞计数对超“米兰标准”肝细胞癌病人肝切除预后的预测价值。方法 回顾性分析 2007年6月至2013年12月在天津医科大学肿瘤医院行肝切除的237例超“米兰标准”肝细胞癌病人的临床资料。利用ROC曲线确定白细胞计数分界值,对病人分组。应用Kaplan-Meier法制作生存曲线,Log-Rank法进行分析。应用COX比例风险模型研究影响预后的危险因素。结果 白细胞计数6.0×109/L为分界值。白细胞较低组和白细胞较高组中位生存时间分别为53.4个月和27.6个月（P=0.002）。白细胞较低组和白细胞较高组中位无复发生存时间分别为20.7个月和12.2个月（P=0.029）。匹配分析后两组间生存时间及无复发生存时间仍有统计学差异。结论 术前白细胞计数可预测超“米兰标准”肝细胞癌病人肝切除的预后。

关键词: 肝细胞癌, 超“米兰标准”, 肝切除术, 白细胞计数, 预后

Abstract: Objective To study the prognostic value of preoperative white blood cell (WBC) count in patients with hepatocellular carcinoma(HCC) beyond Milan criteria after hepatic resection. Methods Clinical data of 237 patients with HCC beyond Milan criteria from Tianjin Medical University Cancer Hospital who underwent hepatectomy from June 2007 to December 2013 were retrospectively studied. The cut-off value of WBC count was determined by receiver operating characteristic curve, which was used to divide the patients in two groups. Survival curves were formed with Kaplan-Meier method and were analyzed using Log-Rank test. Cox proportional hazards model was developed to identify the risk factors of survival. Results WBC count 6.0 ×109/L was the cut-off point between two groups. The median survival time of lower WBC count group and higher WBC count group were 53.4 and 27.6 months, respectively (P=0.002). The median recurrence-free survival of lower WBC count group and higher WBC count group were 20.7 and 12.2 months, respectively(P=0.029). The statistical differences in both survival time and recurrence-free survival remained between two groups after match analysis. Conclusions Preoperative WBC count might predict the prognosis of HCC patients beyond Milan criteria after hepatic resection.

Key words: Hepatocellular carcinoma, Milan criteria, Hepatectomy, White blood cell, Prognosis

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