Gender difference in clinicopathologic features and survival of patients with hepatocellular carcinoma
Gender difference in clinicopathologic features and survival of patients with hepatocellular carcinoma
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DOI：
10.3748/wjg.v10.i11.1547
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发表时间：
2004-06-01
影响因子：
4.3
通讯作者：
Poovorawan, Yong
中科院分区：
文献类型：
--
作者：
Tangkijvanich, Pisit;Mahachai, Varocha;Poovorawan, Yong
目的：探讨性别对肝细胞癌（HCC）患者临床病理特征和生存的影响。方法：对 299 例 HCC 患者的病历进行回顾性分析，比较其临床病理特征和生存与性别的关系。结果：其中男性 260 例（87%），女性 39 例（13%），其中男对女 比例为6.7:1。女性患者的平均血清胆红素水平较低（P=0.03），酗酒比例较低（P=0.002），平均肿瘤尺寸较小（P=0.02），结节型HCC较常见，但块状和弥漫型HCC较少见（P=0.01），Okuda分期较晚期（P=0.04），且与静脉侵犯的相关性较低（P=0.03）。女性患者的中位生存期（14 个月）显着长于男性患者（4 个月）（P=0.004，对数秩检验）。多变量分析表明，血清甲胎蛋白水平高、静脉侵犯、肝外转移和缺乏治疗是不良预后的独立因素。然而，性别并不构成与患者生存相关的预测变量。结论：女性患者的生存率往往高于男性。这些差异可能是由于初次诊断时 HCC 的病理特征更有利，并且女性患者接受根治性治疗的可能性更大。
AIM: To determine the influence of gender on the clinicopathologic characteristics and survival of patients with hepatocellular carcinoma (HCC).METHODS: A retrospective analysis of medical records was performed in 299 patients with HCC and their clinicopathologic features and survival were compared in relation to gender.RESULTS: There were 260 male (87%) and 39 female patients (13%), with a male-to-female ratio of 6.7:1. Female patients had lower mean serum bilirubin levels (P=0.03), lower proportion of alcohol abuse (P=0.002), smaller mean tumor size (P=0.02), more frequent nodular type but less frequent massive and diffuse types of HCC (P=0.01), were less advanced in Okuda's staging (P=0.04), and less frequently associated with venous invasion (P=0.03). The median survivals in females (14 mo) were significantly longer than that of male patients (4 mo) (P=0.004, log-rank test). Multivariate analysis demonstrated that high serum alpha-fetoprotein levels, venous invasion, extrahepatic metastasis and lack of therapy were independent factors related to unfavorable prognosis. However, gender did not constitute a predictive variable associated with patient survival.CONCLUSION: Female patients tend to have higher survival rates than males. These differences were probably due to more favorable pathologic features of HCC at initial diagnosis and greater likelihood to undergo curative therapy in female patients.