CAJ | 학술논문

目的：探讨新疆维吾尔族肝细胞癌（ HCC）患者的临床特征和预后。方法回顾性分析301例维吾尔族HCC患者的临床资料，分为非乙型非丙型肝癌组（ NBC?HCC组）和病毒相关肝癌组（ viral?HCC组）。采用Kaplan?Meier法计算生存率，采用Log rank检验对影响患者预后的因素进行单因素分析，采用Cox多因素对影响患者预后的因素进行多因素分析。结果 NBC?HCC组患者的性别、城乡地区、糖尿病史、体质指数、肝硬化史、临床分期、Child?pugh分级、总胆红素和甲胎蛋白水平与viral?HCC组比较，差异均有统计学意义（均P＜0．05）。全组HCC患者的1、2、3、5年生存率分别为35．6％、20．3％、12．6％和4．5％；NBC?HCC组患者的1、2、3、5年生存率分别为32．2％、18．5％、14．7％和5．2％，viral?HCC组患者的1、2、3、5年生存率分别为38．0％、21．1％、13．5％和4．1％，差异无统计学意义（ P＝0．124）。多因素分析结果显示，年龄、临床分期、门静脉癌栓（ PVTT）、Child?pugh分级、肝动脉化疗栓塞（ TACE）联合放疗或射频消融（ RFA）均为影响HCC患者预后的独立因素（均P＜0．05）。结论NBC?HCC组和viral?HCC组肝癌患者的临床特征不尽相同，具有一定的区域特点。年龄、临床分期、PVTT、Child?pugh分级、TACE联合放疗或RFA为影响HCC患者预后的独立因素。
목적：탐토신강유오이족간세포암（ HCC）환자적림상특정화예후。방법회고성분석301례유오이족HCC환자적림상자료，분위비을형비병형간암조（ NBC?HCC조）화병독상관간암조（ viral?HCC조）。채용Kaplan?Meier법계산생존솔，채용Log rank검험대영향환자예후적인소진행단인소분석，채용Cox다인소대영향환자예후적인소진행다인소분석。결과 NBC?HCC조환자적성별、성향지구、당뇨병사、체질지수、간경화사、림상분기、Child?pugh분급、총담홍소화갑태단백수평여viral?HCC조비교，차이균유통계학의의（균P＜0．05）。전조HCC환자적1、2、3、5년생존솔분별위35．6％、20．3％、12．6％화4．5％；NBC?HCC조환자적1、2、3、5년생존솔분별위32．2％、18．5％、14．7％화5．2％，viral?HCC조환자적1、2、3、5년생존솔분별위38．0％、21．1％、13．5％화4．1％，차이무통계학의의（ P＝0．124）。다인소분석결과현시，년령、림상분기、문정맥암전（ PVTT）、Child?pugh분급、간동맥화료전새（ TACE）연합방료혹사빈소융（ RFA）균위영향HCC환자예후적독립인소（균P＜0．05）。결론NBC?HCC조화viral?HCC조간암환자적림상특정불진상동，구유일정적구역특점。년령、림상분기、PVTT、Child?pugh분급、TACE연합방료혹RFA위영향HCC환자예후적독립인소。
Objective This study was aimed to understand the clinical characteristics and prognosis in Uighur patients with Non?B Non?C hepatocellular carcinoma ( HCC) and virus?related HCC. Methods We retrospectively analyzed the clinical data of 301 Uighur HCC patients, among them, there were 145 NBC?HCC cases and 156 virus?related HCC cases. The overall survival rates of the patients were analyzed by Kaplan?Meier method, and the factors that may influence the prognosis and survival of NBC?HCC patients were analyzed using univariate ( Log rank test ) and multivariate Cox proportional hazard model. Results The differences of the gender, living region, history of diabetes, body mass index ( BMI) , history of cirrhosis, TNM stage, Child?Pugh scores, total bilirubin, and AFP level between the NBC?HCC group and viral?HCC group were statistically significant (P<0.05 for all). The 1?,2?, 3? and 5?year survival rates were 35.6%, 20.3%, 12. 6%, and 4. 5%, respectively, for all the 301 patients, and no significant difference between these two groups in terms of OS ( P>0. 05 ) . Multivariate analysis by Cox model showed that age, TNM staging, PVTT, Child?Pugh scores, TACE combined with radiotherapy or RFA were significant independent prognostic factors (all P<0.05). Conclusions The clinical characteristics in Uighur patients with non?B non?C HCC and hepatitis virus?related HCC are not all the same and HCC in Xinjiang region has certain regional characteristics and features. Age, TNM stages, portal vein tumor thrombus, Child?Pugh scores, and TACE combined with radiotherapy or RFA are significant independent prognostic factors.