Staging systems for predicting survival of patients with hepatocellular carcinoma after surgery.
Staging systems for predicting survival of patients with hepatocellular carcinoma after surgery.
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DOI：
10.3748/wjg.v16.i41.5257
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发表时间：
2010-11
影响因子：
4.3
通讯作者：
Lei-bo Xu;Jie Wang;Chao Liu;Hao-wei Pang;Ya-jin Chen;Q. Ou;Ji-sheng Chen
中科院分区：
文献类型：
--
作者：
Lei-bo Xu;Jie Wang;Chao Liu;Hao-wei Pang;Ya-jin Chen;Q. Ou;Ji-sheng Chen
目的比较肝细胞癌（HCC）患者肝部分切除术（PH）后分期及预后判断。方法回顾性分析1991年1月~ 2004年12月我院438例肝细胞癌患者行肝切除术的临床资料。分别采用中国肿瘤淋巴结转移（TNM）和巴塞罗那临床肝癌（BCLC）分期系统进行肿瘤分期。使用Kaplan-Meier方法绘制HCC患者的生存曲线，并通过对数秩检验比较差异。通过计算受试者工作特征曲线下面积评价各系统预测HCC患者死亡的准确性。结果根据3种分期系统将HCC患者分为I ~ III期、I ~ IV期和A ~ C期。Log-rank检验显示，中国系统3期、TNM I、II期、TNM III、IV期和BCLC 3期HCC患者的累积生存率差异有统计学意义（P < 0.05）。而TNM分期为II期和III期的HCC患者之间无显著性差异。中国和BCLC分期系统预测肝癌患者生存率的准确性高于TNM分期系统。结论中国和BCLC分期系统对肝细胞癌PH后患者的分层和预后判断优于TNM分期系统。
AIM To compare the staging systems for stratifying and predicting the prognosis of patients with hepatocellular carcinoma (HCC) after partial hepatectomy (PH). METHODS Clinical data about 438 HCC patients who underwent PH from January 1991 to December 2004 at our hospital were retrospectively analyzed. Tumor stage was evaluated following the Chinese tumor node metastasis (TNM) and barcelona clinic liver cancer (BCLC) staging systems, respectively. Survival curves for the HCC patients were plotted using the Kaplan-Meier method and differences were compared by the log-rank test. The accuracy of each system for predicting death of HCC patients was evaluated by calculating the area under the receiver operating characteristic curve. RESULTS The HCC patients were classified into stages I-III, stages I-IV and stages A-C, according to the 3 staging systems, respectively. Log-rank test showed that the cumulative survival rate was significantly different for the HCC patients at 3 Chinese system stages, TNM stages I and II, TNM stages III and IV, and 3 BCLC stages (P < 0.05). However, no significant difference was found in the HCC patients at TNM stages II and III. The accuracy of the Chinese and BCLC staging systems was higher than that of the TNM staging system for predicting the survival rate of HCC patients. CONCLUSION The Chinese and BCLC staging systems are better for stratifying and predicting the prognosis of HCC patients after PH than the TNM staging system.