乙肝肝硬化患者并发肝癌的危险因素研究

To elucidate the occurrence rate of hepatocellar carcinoma in patients with post-hepatitis B cirrhosis, and to assess the risk factors for hepatocellular carcinoma (HCC) .A total of 180 patients had been prospectively invested for four years.The occurrence rate of HCC was calculated with Kaplan-Meier method.And the risk factors of HCC were evaluated with Cox regression model.During observation period, the HCC were developed in 30 patients.With multivariate analysis, 4 variables, age (50 years or older) , prothrombin activity (70% or less) , platelet count (less than 60×109/L) , and α-fetopreotein level (50ng/L or higher) , were showed to be independent predictive values for the development of HCC.According to the contribution of each of these factors to the final model, a score ranging from 0 to 4.84 was used for division of patients into 2 different risk groups.The lower risk group included those with score of 2.57 or less (n=99, 8 cases with HCC, cumulative incidence of HCC at 4 years was 8.1%) .While the higher risk group included those with score greater than 2.57 (n=33, 22 cases with HCC, cumulative incidence of HCC at 4 years was 61%) (P=0.00012) .