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目的:建立预测乙型肝炎相关肝细胞性肝癌(HCC)患者切除术后生存情况的危险指数(PI)模型。方法:收集新疆医科大学第一附属医院2007年10月—2009年10月收治的102例乙型肝炎相关HCC行切除术患者的临床资料,Cox风险比例回归方法分析影响患者5年生存的预后的指标,根据分析的结果建立PI模型,并评价所建立模型的准确度。结果:多因素Cox回归模型分析结果显示,中性粒细胞/淋巴细胞比值(NLR)、微血管侵润(MVI)、肿瘤最大直径(MST)、肿瘤数目(AT)、术后行肝动脉灌注化疗栓塞术(TACE)治疗为影响此类患者预后的独立指标(均P<0.05);根据以上指标建立的PI模型:PI=0.317×NLR+0.958×MVI(是=1,否=0)+0.700×MST(<5 cm=0,≥5 cm=1)+0.945×AT(单发=0,多发=1)-1.168×TACE(是=1,否=0);验证结果显示,该PI模型预测患者5年生存的AUC达0.795,界值为1.46,准确度为75.49%。结论:成功建立预测乙型肝炎相关HCC患者切除术后5年生存情况的PI模型,为临床判断该类患者预后及选用合理的治疗方法提供了一定的参考。
Objective: To establish a risk index (PI) model for predicting the survival of patients with hepatocellular carcinoma (HCC) associated with hepatitis B after resection. Methods: The clinical data of 102 patients with HCC undergoing resection of HCC who were treated in the First Affiliated Hospital of Xinjiang Medical University from October 2007 to October 2009 were collected. Cox risk proportional regression analysis was performed to analyze the prognosis of patients with 5-year survival Indicators, based on the analysis of the results of the establishment of PI model, and evaluate the accuracy of the model established. Results: The results of multivariate Cox regression analysis showed that neutrophil / lymphocyte ratio (NLR), microvascular invasion (MVI), maximum tumor diameter (MST), tumor number (AT) Embolization (TACE) was an independent predictor of the prognosis of these patients (all P <0.05); PI model established according to the above indexes: PI = 0.317 × NLR + 0.958 × MVI (= 1, no = 0) +0.700 × MST (<5 cm = 0, ≥5 cm = 1) +0.945 × AT (single = 0, multiple = 1) -1.168 × TACE (= 1, no = 0). The verification results show that the PI model The predicted AUC of 5-year survival was 0.795, the cutoff was 1.46, and the accuracy was 75.49%. Conclusion: The PI model that predicts the 5-year survival rate of patients with hepatitis B-related HCC after resection is successfully established, which will provide some reference for judging the prognosis of these patients and selecting reasonable treatment methods.