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目的:研究与肝癌分化程度不良相关的临床危险因素。方法:回顾性分析74例行肝癌根治性切除术的患者,提取术前人口统计学资料、实验室检验资料、常规超声及超声造影诊断资料,分析其与不同肝癌分化程度之间的关系。结果:74例患者分为高分化组(41例)和中-低分化组(33例),两组患者的年龄、性别差异无统计学意义。单因素分析结果显示两组患者在血清总胆红素(TBIL)≥20μmol/L、血清甲胎蛋白(AFP)≥400 ng/m L(P=0.004)、凝血酶原时间(PT)≥14 s、超声造影“快出”增强模式(P=0.017)的差异具有统计学意义。多因素分析结果显示血清TBIL≥20μmol/L、血清AFP≥400 ng/m L、PT≥14 s、超声造影“快出”增强模式具有统计学意义,提示以上指标是HCC分化程度下降的独立危险因素。结论:血清AFP≥400 ng/m L、超声造影“快出”增强模式、血清TBIL≥20μmol/L以及PT≥14 s是HCC分化程度不良的独立危险因素。这些信息可能帮助临床医生更好地制定围术期的肿瘤综合诊疗方案。
Objective: To study the clinical risk factors associated with poorly differentiated HCC. Methods: A total of 74 patients undergoing radical resection of liver cancer were retrospectively analyzed. The preoperative demographic data, laboratory test data, conventional ultrasound and contrast-enhanced ultrasound were used to analyze the relationship between them and the differentiation degree of different HCCs. Results: 74 patients were divided into well-differentiated group (41 cases) and moderate-poorly differentiated group (33 cases). There was no significant difference in age and sex between the two groups. The results of univariate analysis showed that there was no significant difference between the two groups in the serum levels of total bilirubin (TBIL) ≥20μmol / L, serum AFP≥400ng / m L (P = 0.004), prothrombin time s, and contrast enhanced ultrasound (P = 0.017) had a statistically significant difference. Multivariate analysis showed that serum TBIL≥20μmol / L, serum AFP≥400ng / m L, PT≥14s, and CEUS “fasting ” enhancement mode was statistically significant, suggesting that the above indexes were decreased in HCC differentiation Independent risk factors. CONCLUSIONS: Serum AFP≥400 ng / m L, contrast enhanced ultrasound, “fasting” enhancement, serum TBIL≥20 μmol / L and PT≥14 s are independent risk factors for poorly differentiated HCC. This information may help clinicians better develop perioperative oncology programs.