CAJ | 학술논문

目的评价肝癌患者术前外周血CD4+/CD8+比值对肝癌患者术后复发的预测价值.方法回顾性分析中山大学附属第五医院67例肝癌行肝部分切除患者的临床资料.根据患者术前外周静脉血CD4+/CD8+比值大小分为低比值组(CD4 +/CD8+比值＜1)和高比值组(CD4+/CD8+比值≥1).术后应用门诊、电话方式随访至2013年6月.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≥400 μg/L、肿瘤最大径＞5 cm、肿瘤数目＞3个、CD4+/CD8+ ＜1、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＜0.05).Cox回归分析显示术前CD4+/CD8+＜1、肿瘤数目＞3个以及门静脉癌栓是肝癌术后复发的独立危险因素(P＜0.05).结论术前CD4 +/CD8+＜1是影响肝癌患者术后复发的独立危险因素,对肝癌患者的预后具有预测价值.
목적 평개간암환자술전외주혈CD4+/CD8+비치대간암환자술후복발적예측개치.방법 회고성분석중산대학부속제오의원67례간암행간부분절제환자적림상자료.근거환자술전외주정맥혈CD4+/CD8+비치대소분위저비치조(CD4 +/CD8+비치＜1)화고비치조(CD4+/CD8+비치≥1).술후응용문진、전화방식수방지2013년6월.이Cox회귀모형대술후복발정황진행상관인소분석.결과 단인소분석제시,술전AFP≥400 μg/L、종류최대경＞5 cm、종류수목＞3개、CD4+/CD8+ ＜1、혈관침범급절연양성、문정맥암전시영향간암간절제술후무류생존적위험인소(P＜0.05).Cox회귀분석현시술전CD4+/CD8+＜1、종류수목＞3개이급문정맥암전시간암술후복발적독립위험인소(P＜0.05).결론 술전CD4 +/CD8+＜1시영향간암환자술후복발적독립위험인소,대간암환자적예후구유예측개치.
Objective To study the predictive value of preoperative blood CD4 +/CD8 + ratio in postoperative recurrence after hepatectomy for patients with hepatocellular carcinoma.Methods The clinical data of 67 patients who underwent hepatectomy for hepatocellular carcinoma at The Fifth Hospital Affiliated to Sun Yat-sen University were analyzed retrospectively.Using the preoperative blood CD4 +/CD8 + ratio,these patients were divided into 2 groups,the CD4 +/CD8 + ＜ 1 group and the CD4 +/CD8 + ≥ 1 group.These patients were followed up at the outpatient clinic and/or by telephone till June 2013.The Cox ratio risk pattern analysis was used to determine the significant risk factors of tumor recurrence.Results On univariate analysis,preoperative AFP ≥400 μg/L,maximum diameter of tumor ＞ 5 cm,number of tumor ＞ 3,CD4 +/CD8 + ＜ 1,vascular invasion,positive resection margin,and portal vein tumor thrombus were risk factors of poor disease-free survival (P ＜ 0.05).On multivariant analysis,CD4 +/CD8 + ＜ 1,number of tumor ＞ 3,and portal vein tumor thrombus were independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinoma (P ＜ 0.05).Conclusions Preoperative CD4 +/CD8 + ＜ 1 was an independent adverse predictor of poor disease-free survival.It was valuable in predicting postoperative recurrence of hepatocellular carcinoma.