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乙肝相关性肝癌BCLC-A期患者术后早期复发转移的危险因素分析

时间:2019-07-31

Cancer statistics in China, 2015


ABSTRACT:With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China’s massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high‐quality data from an additional number of population‐based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population‐based cancer registries (2009‐2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000‐2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age‐standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (−1.4% per year; P < .05) and females (−1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations. CA Cancer J Clin 2016;66:115–132. © 2016 American Cancer Society. 


目的:探讨乙肝相关性肝癌BCLC-A期患者术后早期复发转移的危险因素分析。方法:回顾性分析2013年11月至2016年06月在某医院行肝细胞癌切除术的210例BCLC-A期患者的临床资料,采用多因素Logistic回归分析影响HCC患者术后早期复发的相关危险因素,应用Kaplan-Meier法作无瘤生存率的分析,采用Log-Rank检验作相关临床病理因素的分析。结果:单因素分析结果示,甲胎蛋白(AFP)、中性粒细胞和淋巴细胞绝对数比值(NLR)、乙肝病毒表面抗原(HBsAg)及术中输血与肝细胞癌术后早期复发相关(P<0.05),多因素分析表明,AFP>400ng/ml是肝细胞癌术后早期复发的独立危险因素(P=0.008)。乙肝病毒DNA(HBV DNA)阳性可影响HCC术后无病生存率(P=0.030),HBV-DNA阳性患者术后6个月、12个月和24个月的无瘤生存率分别为71.7%、60.7%和46.5%,低于HBV-DNA阴性患者的84.4%、71.5%和61.1%。HBV-DNA阳性组和HBV-DNA阴性组患者在肝硬化病史、谷草转氨酶(AST)、谷丙转氨酶(ALT)和中性粒细胞和淋巴细胞比值(NLR)的差异有统计学意义(P<0.05)。围手术期积极抗病毒治疗能降低乙肝相关性HCC术后复发率(P<0.05)。结论:AFP是HBV相关性肝癌BCLC-A期患者术后早期复发转移的独立危险因素,HBV-DNA阳性可降低HBV相关性肝癌BCLC-A期患者术后无瘤生存期,围手术期抗病毒治疗可提高HBV相关性肝癌BCLC-A期患者术后无瘤生存期。 


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乙肝相关性肝癌BCLC-A期患者术后早期复发转移的危险因素分析

发布时间:2019-07-31

Cancer statistics in China, 2015


ABSTRACT:With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China’s massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high‐quality data from an additional number of population‐based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population‐based cancer registries (2009‐2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000‐2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age‐standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (−1.4% per year; P < .05) and females (−1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations. CA Cancer J Clin 2016;66:115–132. © 2016 American Cancer Society. 


目的:探讨乙肝相关性肝癌BCLC-A期患者术后早期复发转移的危险因素分析。方法:回顾性分析2013年11月至2016年06月在某医院行肝细胞癌切除术的210例BCLC-A期患者的临床资料,采用多因素Logistic回归分析影响HCC患者术后早期复发的相关危险因素,应用Kaplan-Meier法作无瘤生存率的分析,采用Log-Rank检验作相关临床病理因素的分析。结果:单因素分析结果示,甲胎蛋白(AFP)、中性粒细胞和淋巴细胞绝对数比值(NLR)、乙肝病毒表面抗原(HBsAg)及术中输血与肝细胞癌术后早期复发相关(P<0.05),多因素分析表明,AFP>400ng/ml是肝细胞癌术后早期复发的独立危险因素(P=0.008)。乙肝病毒DNA(HBV DNA)阳性可影响HCC术后无病生存率(P=0.030),HBV-DNA阳性患者术后6个月、12个月和24个月的无瘤生存率分别为71.7%、60.7%和46.5%,低于HBV-DNA阴性患者的84.4%、71.5%和61.1%。HBV-DNA阳性组和HBV-DNA阴性组患者在肝硬化病史、谷草转氨酶(AST)、谷丙转氨酶(ALT)和中性粒细胞和淋巴细胞比值(NLR)的差异有统计学意义(P<0.05)。围手术期积极抗病毒治疗能降低乙肝相关性HCC术后复发率(P<0.05)。结论:AFP是HBV相关性肝癌BCLC-A期患者术后早期复发转移的独立危险因素,HBV-DNA阳性可降低HBV相关性肝癌BCLC-A期患者术后无瘤生存期,围手术期抗病毒治疗可提高HBV相关性肝癌BCLC-A期患者术后无瘤生存期。 


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