CAJ | 학술논문

目的：评价肝癌患者术前Fib-4指数对肝癌肝切除术后复发的预测价值。方法回顾性分析67例行肝部分切除肝癌患者的临床资料，根据患者术前Fib-4指数的大小分为低指数组（Fib-4指数＜3．25）和高指数组（Fib-4指数≥3．25），术后应用门诊、电话方式随访，以Cox回归模型对术后复发情况进行相关因素分析。结果单因素分析提示，术前AFP≥400μg/L、肿瘤最大直径＞5 cm、肿瘤数目＞3个、Fib-4指数≥3．25、血管侵犯及切缘阳性、门静脉癌栓是影响肝癌肝切除术后无瘤生存的危险因素（P均＜0．05），Cox回归分析显示术前Fib-4指数≥3．25、肿瘤数目＞3个及门静脉癌栓是肝癌术后复发的独立危险因素（P均＜0．05）。结论术前Fib-4指数≥3．25是影响肝癌患者术后复发的独立危险因素。
목적：평개간암환자술전Fib-4지수대간암간절제술후복발적예측개치。방법회고성분석67례행간부분절제간암환자적림상자료，근거환자술전Fib-4지수적대소분위저지수조（Fib-4지수＜3．25）화고지수조（Fib-4지수≥3．25），술후응용문진、전화방식수방，이Cox회귀모형대술후복발정황진행상관인소분석。결과단인소분석제시，술전AFP≥400μg/L、종류최대직경＞5 cm、종류수목＞3개、Fib-4지수≥3．25、혈관침범급절연양성、문정맥암전시영향간암간절제술후무류생존적위험인소（P균＜0．05），Cox회귀분석현시술전Fib-4지수≥3．25、종류수목＞3개급문정맥암전시간암술후복발적독립위험인소（P균＜0．05）。결론술전Fib-4지수≥3．25시영향간암환자술후복발적독립위험인소。
Objective To investigate the postoperative recurrence predictive value of preoperative Fib -4 index on hep-atocellular carcinoma patients .Methods Clinical data of 67 cases of hepatocellular carcinoma underwent hepatectomy in the 5th Hospital Affiliated to Sun Yat-sen University were analyzed retrospectively .According to the preoperative Fib-4 in-dex, these patients were divided into 2 groups, one was Fib-4 index<3.25, the other was Fib-4 index≥3.25.These pa-tients were follow-up visited by using outpatient service and telephone till 2013 September .Cox ratio risk pattern analysis was used for the recurrent correlative factors .Results Univariate analysis showed that preoperative AFP≥400 ug/L, the maximum diameter of the tumor >5cm, the number of tumor>3, Fib-4 index≥3.25, vascular invasion, positive resection margin and portal vein tumor thrombus were all risk factors of poor disease -free survival (all P<0.05).Cox regression a-nalysis revealed that Fib-4 index≥3.25, the number of tumor >3 and portal vein tumor thrombus were independent predic-tors of poor disease-free survival after hepatectomy for hepatocellular carcinoma (all P<0.05).Conclusion Preoperative Fib-4 index≥3.25 is an independent risk factor for predicting the postoperative recurrence of patients with hepatocellular carcinoma.