1302例单中心观察性肝细胞癌真实世界队列的流行病学特征与预后

何雅婧; 张植明; 何伟猛; 侯金林

doi:10.3969/j.issn.1001-5256.2019.05.014

1302例单中心观察性肝细胞癌真实世界队列的流行病学特征与预后

DOI: 10.3969/j.issn.1001-5256.2019.05.014

南方医科大学南方医院感染内科暨肝病中心

基金项目:

中国肝炎防治基金会天晴肝病研究基金课题(TQGB20190270)；南方医科大学南方医院“临床研究专项”(2018CR006)；广州市健康医疗协同创新重大计划(201803040013)；

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中图分类号: R735.7
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出版历程
- 收稿日期: 2019-02-12
- 出版日期: 2019-05-20

Epidemiological characteristics and prognosis of hepatocellular carcinoma: A single-center observational real-world cohort study of 1302 cases

Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University

Research funding:

摘要

摘要: 目的探讨肝细胞性肝癌（HCC）的整体流行病学特征及临床预后。方法持续记录2011年1月1日-2017年10月31日在南方医院肝病中心确诊并住院诊治的1302例HCC患者的临床及随访资料,分析其流行病学及复发、生存特征。计数资料组间比较采用χ2检验,Kaplan-Meier计算生存率与复发率,log-rank检验比较组间差异。结果 1302例患者男:女8. 50:1,平均（52. 46±11. 51）岁。病因以HBV感染者最多,共1163例（89. 32%）,其中HBeAg阳性者:HBeAg阴性者1:3. 05; HCV 32例（2. 46%）,HBV合并HCV感染者12例（0. 92%）。1012例合并肝硬化（77. 73%）。肝功能分级中,以Child-Pugh A～B和白蛋白-胆红素（ALBI） 1～2级为主。巴塞罗那（BCLC）分期:0期76例（5. 84%）,A期474例（36. 41%）,B期236例（18. 13%）,C期504例（38. 71%）,D期12例（0. 92%）。261例（20. 05%）基线治疗即获根治,手术为主要治疗方法;其余1041...
- 乙型肝炎病毒 /
- 癌,肝细胞 /
- 预后 /
- 队列研究
Abstract: Objective To investigate the epidemiological characteristics and clinical prognosis of hepatocellular carcinoma ( HCC) . Methods 1302 HCC patients who were diagnosed and treated in Hepatology Center, Nanfang Hospital, from January 1, 2011 to October 31, 2017 were enrolled, and their clinical and follow-up data were recorded to analyze epidemiological characteristics, recurrence, and survival. The chi-square test was used for comparison of categorical variables, and the Kaplan-Meier method was used to calculate survival and recurrence rates, log-rank test was used for comparison. Results 1302 patients with a male/female ratio of 8. 50 : 1 and a mean age of52. 46 ± 11. 51 years. Of all 1302 patients, 1163 ( 89. 32%) had HBV infection, with a HBeAg-positive/HBeAg-negative ratio of 1: 3. 05; 32 ( 2. 46%) had HCV infection, and 12 ( 0. 92%) had HBV and HCV infections. Of all patients, 1012 ( 77. 73%) had liver cirrhosis. As for liver function classification, most patients are had Child-Pugh class A-B and albumin-bilirubin grade 1-2 liver disease.As for Barcelona Clinic Liver Cancer ( BCLC) stage, 76 patients ( 5. 84%) had BCLC stage 0, 474 ( 36. 41%) had stage A, 236 ( 18. 13%) had stage B, 504 ( 38. 71%) had stage C, and 12 ( 0. 92%) had stage D HCC. Of all 1302 patients, 261 ( 20. 05%) received radical treatment at baseline, and surgery was the main treatment method; among the remaining 1041 patients ( 79. 95%) , most of them received transarterial chemoembolization. The follow-up time ranged from 0. 27 to 88. 70 months, with a median follow-up time of 13. 33 months.The 5-year median overall survival time of all patients was 21. 53 ± 1. 59 months ( 95% confidence interval [CI]: 18. 411-24. 656) , and there was a significant difference in survival time between the patients with different BCLC stages ( P < 0. 001) . In the patients who received radical treatment, the 5-year median overall survival time was not obtained, and their 5-year median recurrence-free survival time was40. 90 ± 4. 81 months ( 95% CI: 31. 467-50. 333) . Conclusion HCC has the epidemiological characteristics from the aspects of demography, etiology, tumor features, and treatment and prognosis, and there are still problems such as a low rate of identification in the early stage, a low rate of radical treatment, and a short survival time. Strategies for HCC prevention and treatment require further investigation and improvement.
- carcinoma, hepatocellular /
- hepatitis B virus /
- prognosis /
- cohort studies

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