原发性肝癌发生血管侵犯的危险因素分析

常秀娟; 陆荫英; 荣光华; 刘泽; 陈艳; 许桂林; 高旭东; 楼敏; 王春平; 杨永平; 曾珍

doi:10.3969/j.issn.1001-5256.2018.05.022

原发性肝癌发生血管侵犯的危险因素分析

DOI: 10.3969/j.issn.1001-5256.2018.05.022

解放军第三〇二医院肝脏肿瘤诊疗与研究中心

基金项目:

国家自然科学基金面上项目(81372248)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2017-11-16
- 出版日期: 2018-05-20

Risk factors for vascular invasion of primary liver cancer

Liver Cancer Treatment and Research Center, 302 Hospital of PLA

Research funding:

摘要

摘要: 目的探讨影响原发性肝癌血管侵犯的危险因素。方法收集2013年1月-2014年6月于解放军第三○二医院住院的211例肝癌患者的临床资料,其中133例用于logistic回归模型拟合,78例用于该模型的检验。原发性肝癌血管侵犯影响因素分析采用单因素和多因素logistic回归分析,并建立回归模型,绘制受试者工作特征曲线（ROC曲线）,确定预测血管侵犯模型的最佳临界值。结果单因素logistic回归分析显示,肿瘤直径、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、纤维蛋白原（Fb）和淋巴结转移为肝癌血管侵犯的危险因素（95%可信区间:1.3761.846、1.8474.195、1.0081.024、1.6083.274,P值均=0）;经多因素logistic回归分析筛选出肿瘤直径、PLR、NLR、Fb（95%可信区间:1.2501.815、0.1731.998、1.4114.397、1.0082....
- 肝肿瘤 /
- 血管侵犯 /
- 危险因素 /
- logistic模型
Abstract: Objective To investigate the risk factors for vascular invasion of primary liver cancer ( PLC) . Methods A retrospective analysis was performed for the clinical data of 211 patients with liver cancer who were hospitalized in 302 Hospital of PLA from January 2013 to June 2014. The logistic regression model fitting was used for the data of 133 patients, and the data of the other 78 patients was used for the verification of this model. Univariate and multivariate logistic regression analyses were used to identify the influencing factors for vascular invasion of PLC; the logistic regression model was established and the receiver operating characteristic ( ROC) curve was plotted to determine the optimal cut-off value of this model. Results The univariate logistic regression analysis showed that tumor diameter ( odds ratio [OR]= 1. 594, 95% confidence interval [CI]: 1. 376-1. 846, P = 0) , neutrophil-lymphocyte ratio ( NLR) ( OR = 2. 783, 95% CI: 1. 847-4. 195, P = 0) , platelet-to-lymphocyte ratio ( PLR) ( OR = 1. 016, 95% CI: 1. 008-1. 024, P = 0) , fibrinogen ( Fb) ( OR = 2. 295, 95% CI: 1. 608-3. 274, P = 0) , and lymph node metastasis ( OR = 11. 664, 95% CI: 3. 744-36. 338, P = 0) were risk factors for vascular invasion of PLC; the multivariate logistic regression analysis showed that tumor diameter ( OR = 1. 506, 95% CI: 1. 250-1. 815, P =0) , PLR ( OR = 1. 499, 95% CI: 0. 173-0. 998, P = 0. 022) , NLR ( OR = 2. 491, 95% CI: 1. 411-4. 397, P = 0. 002) , and Fb ( OR = 1. 486, 95% CI: 1. 008-2. 193, P = 0. 046) were used for regression model fitting. The area under the ROC curve was 0. 927 ( 95% CI: 0. 881-0. 973) , and the ROC curve showed that the model had the highest sensitivity of 92. 9%, the highest specificity of86. 5%, and a prediction accuracy rate of 82. 79%. Conclusion The regression equation containing tumor diameter, PLR, NLR, and Fb established in this study has a high prediction accuracy of vascular invasion of PLC and provides a reference for early warning of vascular invasion of PLC.
- liver neoplasms /
- vascular invasion /
- risk factors /
- logistic models

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