中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2014年
8期
460-463
,共4页
许泽清%张林启%何巧%张祥松
許澤清%張林啟%何巧%張祥鬆
허택청%장림계%하교%장상송
肝细胞癌%肝移植%18F-脱氧葡萄糖%正电子发射断层显像%体层摄影术%复发
肝細胞癌%肝移植%18F-脫氧葡萄糖%正電子髮射斷層顯像%體層攝影術%複髮
간세포암%간이식%18F-탈양포도당%정전자발사단층현상%체층섭영술%복발
Hepatocellular carcinoma%Liver transplantation%18F-FDG%Positron emission tomography%Tomography%Recurrence
目的 基于肝移植术前氟代脱氧葡萄糖-正电子发射型计算机断层显像(17F-FDGPET/CT)结果探讨影响肝细胞癌(HCC)肝移植术后复发的危险因素.方法 选择2008年9月至2012年1 1月接受肝移植的54例HCC患者.单因素分析中,存活率的计算采用Kaplan-Meier方法,存活率的组间比较采用Logrank检验;应用ROC曲线探讨18F-FDG PET/CT显像的靶/本(T/B)值影响术后HCC复发的最佳临界值.采用Cox回归模型分析影响肿瘤复发的独立危险因素.结果 54例受者随访期间共出现肿瘤复发26例(26/54,48.1％),全组受者术后0.5、1、2、3和4年的累积肿瘤无复发存活率分别为92.6％、66.7 1％、52.2％、49.1％和49.1％;单因素结果显示,影响HCC肝移植受者术后肿瘤复发的因素为PET显像(P=0.003)、肿瘤最大直径(P＜0.001)、肿瘤数目(P=0).001)、术前甲胎蛋白(AFP)水平(P＜0.001)、肿瘤分级(P=0.015);ROC曲线分析结果显示,T/B值=1.69是影响HCC术后复发的最佳临界值;Cox回归多因素分析结果显示,T/B值(相对危险度=14.377,P＜0.001)和术前AFP水平(相对危险度=3.124,P=0.012)是影响HCC肝移植后肿瘤复发和转移的独立危险因素.结论 18 F-FDG PET/CT的T/B值＞1.69、术前AFP水平＞400 μg/L等生物学因素是影响HCC肝移植后肿瘤复发的独立危险因素.
目的 基于肝移植術前氟代脫氧葡萄糖-正電子髮射型計算機斷層顯像(17F-FDGPET/CT)結果探討影響肝細胞癌(HCC)肝移植術後複髮的危險因素.方法 選擇2008年9月至2012年1 1月接受肝移植的54例HCC患者.單因素分析中,存活率的計算採用Kaplan-Meier方法,存活率的組間比較採用Logrank檢驗;應用ROC麯線探討18F-FDG PET/CT顯像的靶/本(T/B)值影響術後HCC複髮的最佳臨界值.採用Cox迴歸模型分析影響腫瘤複髮的獨立危險因素.結果 54例受者隨訪期間共齣現腫瘤複髮26例(26/54,48.1％),全組受者術後0.5、1、2、3和4年的纍積腫瘤無複髮存活率分彆為92.6％、66.7 1％、52.2％、49.1％和49.1％;單因素結果顯示,影響HCC肝移植受者術後腫瘤複髮的因素為PET顯像(P=0.003)、腫瘤最大直徑(P＜0.001)、腫瘤數目(P=0).001)、術前甲胎蛋白(AFP)水平(P＜0.001)、腫瘤分級(P=0.015);ROC麯線分析結果顯示,T/B值=1.69是影響HCC術後複髮的最佳臨界值;Cox迴歸多因素分析結果顯示,T/B值(相對危險度=14.377,P＜0.001)和術前AFP水平(相對危險度=3.124,P=0.012)是影響HCC肝移植後腫瘤複髮和轉移的獨立危險因素.結論 18 F-FDG PET/CT的T/B值＞1.69、術前AFP水平＞400 μg/L等生物學因素是影響HCC肝移植後腫瘤複髮的獨立危險因素.
목적 기우간이식술전불대탈양포도당-정전자발사형계산궤단층현상(17F-FDGPET/CT)결과탐토영향간세포암(HCC)간이식술후복발적위험인소.방법 선택2008년9월지2012년1 1월접수간이식적54례HCC환자.단인소분석중,존활솔적계산채용Kaplan-Meier방법,존활솔적조간비교채용Logrank검험;응용ROC곡선탐토18F-FDG PET/CT현상적파/본(T/B)치영향술후HCC복발적최가림계치.채용Cox회귀모형분석영향종류복발적독립위험인소.결과 54례수자수방기간공출현종류복발26례(26/54,48.1％),전조수자술후0.5、1、2、3화4년적루적종류무복발존활솔분별위92.6％、66.7 1％、52.2％、49.1％화49.1％;단인소결과현시,영향HCC간이식수자술후종류복발적인소위PET현상(P=0.003)、종류최대직경(P＜0.001)、종류수목(P=0).001)、술전갑태단백(AFP)수평(P＜0.001)、종류분급(P=0.015);ROC곡선분석결과현시,T/B치=1.69시영향HCC술후복발적최가림계치;Cox회귀다인소분석결과현시,T/B치(상대위험도=14.377,P＜0.001)화술전AFP수평(상대위험도=3.124,P=0.012)시영향HCC간이식후종류복발화전이적독립위험인소.결론 18 F-FDG PET/CT적T/B치＞1.69、술전AFP수평＞400 μg/L등생물학인소시영향HCC간이식후종류복발적독립위험인소.
Objective To analyze the risk factors of hepatocellular carcinoma (HCC) recurrence after liver transplantation based on 18F-FDG PET/CT.Method We respectively analyzed 54 cases of HCC patients who accepted liver transplantation from 2008 September to 2012 November.The clinicopathological features of 54 patients were analyzed by univariate and multivariate analysis to determine the risk factors of HCC recurrence after liver transplantation.The ROC curve was drawn to determine the optimal cutoff value of T/B that affects HCC recurrence after liver transplantation.Result The total incidence of HCC recurrence was 48.1％ (26/54); the disease-free survival (DFS) rate of 0.5 year,1 year and 2 years after transplantation in 54 patients was 92.6％,66.7％,52.2％,49.1 ％ and 49.1％ respectively.The univariate analysis results showed that there were 5 variables to affect HCC recurrence,namely PET imaging,tumor size,tumor number,preoperative AFP level,and tumor degree.On ROC curve analysis,the optimal cutoff value for T/B was 1.69.The multivariate analysis concluded that T/B,and preoperative AFP level were independent factors.Conclusion T/B ＞1.69 and preoperative AFP level ＞400 μg/L are important biological factors of HCC recurrence after liver transplantation.
