影响肝细胞癌骨转移的危险因素分析

发布时间：2018-06-19 14:23

  本文选题：肝细胞癌 + 骨转移　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:分析肝细胞癌骨转移病人的一般人口学、临床以及病理资料,探讨肝细胞癌骨转移发生的危险因素。方法:本次研究于2014年1月到2016年6月在山西省肿瘤医院收集肝细胞癌患者共209例。明确诊断为肝细胞癌原发病灶骨转移患者作为病例组,共110人;肝细胞癌非骨转移病例99例为对照组。将可能影响肝细胞癌病人发生骨转移的相关因素进行分析。同时使用logistic回归分析模型进行多因素校正分析。结果:对相关影响因素进行分析提示,患者性别、婚姻状况、职业、文化程度、常住地、体重指数、口味、经常饮酒和饮茶、性格、婚姻满意程度、亲朋好友关系、是否经常发脾气、遇事态度、生活压力、经历重大事件、Tbil、ALB、ALT、ALP、GGT、HBV是否感染、HBV DNA水平、镜下脉管癌栓、肝门阻断时间和否发生肝硬化与肝细胞癌骨转移发生无关。而年龄、吸烟情况、血清AFP水平、γ-GT水平、肿瘤个数、肿瘤最大直径、癌细胞存在微血管侵犯、肿瘤分化程度、原发病灶控制情况、KPS评分、SUV水平和放疗后SUV下降情况是影响肝细胞癌骨转移发生的相关危险因素。logistic回归分析模型进行多因素校正分析显示,肿瘤个数、肿瘤分化程度、KPS评级、原发病灶控制情况和血清γ-GT水平是肝细胞癌骨转移发生的独立危险因素。结论:1.年龄、吸烟与否、血清AFP水平、γ-GT水平、肿瘤情况、肿瘤分化程度、肿瘤最大直径、肝癌细胞是否存在微血管侵犯、原发病灶控制情况好坏、KPS评分、SUV和放疗后SUV下降程度与肝细胞癌患者是否发生骨转移有关。2.肿瘤多发、肿瘤分化程度差、原发病灶控制情况差以及γ-GT≥150IU/L是肝细胞癌骨转移的独立危险因素。
[Abstract]:Objective: to analyze the general demographic, clinical and pathological data of patients with bone metastases from hepatocellular carcinoma (HCC), and to explore the risk factors of bone metastasis in hepatocellular carcinoma (HCC). Methods: 209 patients with hepatocellular carcinoma were collected from January 2014 to June 2016 in Shanxi Provincial Cancer Hospital. 110 patients with primary bone metastasis of hepatocellular carcinoma and 99 patients with non-bone metastasis of hepatocellular carcinoma were selected as the case group and the control group respectively. The factors related to bone metastasis in hepatocellular carcinoma patients were analyzed. At the same time, the logistic regression model is used for multivariate calibration analysis. Results: the related factors were analyzed and concluded: sex, marital status, occupation, education, residence, body mass index, taste, frequent drinking and drinking tea, personality, marital satisfaction, family and friends, Whether you often lose your temper, get into trouble, live under pressure, experience major events, or not, whether HBV DNA is infected with ALP GGTV HBV, vascular cancer thrombus under microscope, the time of hepatic hilus occlusion and the occurrence of liver cirrhosis are not related to the occurrence of bone metastasis in hepatocellular carcinoma (HCC). Age, smoking status, serum AFP level, 纬 -GT level, tumor number, tumor maximum diameter, microvascular invasion of cancer cells, tumor differentiation degree, KPS score and SUV decline after radiotherapy were related risk factors of bone metastasis of hepatocellular carcinoma. Logistic regression analysis showed that tumor number and tumor differentiation degree were higher than that of KPS. Primary focus control and serum 纬-GT levels are independent risk factors for bone metastasis in hepatocellular carcinoma. Conclusion 1. Age, smoking or not, serum AFP level, 纬 -GT level, tumor status, tumor differentiation, tumor maximum diameter, microvascular invasion of hepatoma cells, The control of primary foci was correlated with the decrease of SUV and SUV after radiotherapy in patients with hepatocellular carcinoma (HCC). Multiple tumors, poor differentiation, poor control of primary lesions and 纬 -GT 鈮，

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