詹泽锋, 洪建文, 林健群, 杨熙, 黄鑫. 我国肝细胞癌巴塞罗那分期中晚期病人精确临床分期方法研究[J]. 蚌埠医科大学学报, 2017, 42(8): 1054-1058. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.013
    引用本文: 詹泽锋, 洪建文, 林健群, 杨熙, 黄鑫. 我国肝细胞癌巴塞罗那分期中晚期病人精确临床分期方法研究[J]. 蚌埠医科大学学报, 2017, 42(8): 1054-1058. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.013
    ZHAN Ze-feng, HONG Jian-wen, LIN Jian-qun, YANG Xi, HUANG Xin. Study on the accurate clinical staging method of Barcelona Clinic Liver Cancer stage B and C in hepatocellular carcinoma[J]. Journal of Bengbu Medical University, 2017, 42(8): 1054-1058. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.013
    Citation: ZHAN Ze-feng, HONG Jian-wen, LIN Jian-qun, YANG Xi, HUANG Xin. Study on the accurate clinical staging method of Barcelona Clinic Liver Cancer stage B and C in hepatocellular carcinoma[J]. Journal of Bengbu Medical University, 2017, 42(8): 1054-1058. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.013

    我国肝细胞癌巴塞罗那分期中晚期病人精确临床分期方法研究

    Study on the accurate clinical staging method of Barcelona Clinic Liver Cancer stage B and C in hepatocellular carcinoma

    • 摘要: 目的:研究巴塞罗那(BCLC)分期中晚期(B期、C期)肝细胞癌病人更精确的亚分期方法。方法:854例中晚期肝细胞癌病人纳入研究,其中BCLC分期B期429例,BCLC分期C期425例。比较总生存率、相关的危险因素,据此进行亚分期。结果:BCLC分期B期分为B1期(肿瘤直径≤ 5 cm,Child-Pugh A或B级)、B2期(肿瘤直径>5 cm,Child-Pugh A级)、B3期(肿瘤直径>5cm,Child-Pugh B级);BCLC分期C期分为C1期(不伴门脉癌栓,不伴肝外转移)、C2期(仅伴门脉癌栓,或仅伴肝外转移)、C3期(同时伴门脉癌栓和肝外转移)。BCLC分期B期病人肿瘤直径≤ 5 cm时,肝功能Child-Pugh分级不影响预后;B3期的1年生存率和C1期的1年生存率差异无统计学意义(P>0.05)。结论:现有的BCLC分期对于中晚期肝癌病人预后的预测精确性还不够,对其进行亚分期对病人的预后预测和治疗方案的选择有很大帮助。

       

      Abstract: Objective:To investigate the accurate clinical substaging of Barcelona Clinic Liver Cancer(BCLC) stage B and C.Methods:A total of 854 intermediate and advanced hepatocellular carcinoma(HCC)patients including 429 cases of BCLC stage B and 425 cases of BCLC stage C were studied.Overall survival and related risk factor in all cases were analyzed,and all patients were substaged.Results:BCLC stage B could be subdivided into the stage B1(tumor size ≤ 5 cm and Child-Pugh A or B),B2(tumor size >5 cm and Child-Pugh A) and B3(tumor size >5cm and Child-Pugh B).BCLC stage C could be subdivided into the stage C1(no portal vein invasion and extra-hepatic metastasis),C2(portal vein invasion or extra-hepatic metastasis) and C3(portal vein invasion and extra-hepatic metastasis).At BCLC stage B patients with tumor diameter ≤ 5 cm,the Child-Pugh staging of liver function did not affect the prognosis.The difference of 1-year survival rate between stage B3 and C1 patients was not statistically significant(P>0.05).Conclusions:The accuracy of BCLC staging in predicting the prognosis of patients with intermediate and advanced HCC is not enough,and the substaging might be useful for determining the prognosis of patient and guiding treatment strategies.

       

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