| 余 斌,丁佑铭,廖晓锋.符合米兰标准、UCSF标准和上海复旦标准的单发肝癌肝移植受者的预后比较：一项基于SEER数据库的回顾性研究[J].中国肿瘤,2018,27(8):613-618. |
| 符合米兰标准、UCSF标准和上海复旦标准的单发肝癌肝移植受者的预后比较：一项基于SEER数据库的回顾性研究 |
| Prognosis of Patients with Single Hepatocellular Carcinoma Meeting Milan Criteria，UCSF Criteria or Shanghai Criteria After Liver Transplantation：A Retrospective Study Based on SEER Database |
| 投稿时间：2018-03-19 |
| DOI：10.11735/j.issn.1004-0242.2018.08.A010 |
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| 中文关键词: 肝细胞癌 肝移植 标准 预后 |
| 英文关键词:hepatocellular carcinoma liver transplantation criteria prognosis |
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| 中文摘要: |
| 摘 要：［目的］ 比较符合“米兰标准”、“UCSF标准”和“上海复旦标准”的单发肝癌肝移植受者的预后情况，以期验证单发肝癌肝移植受者拓展标准的科学性和有效性。［方法］基于美国SEER数据库2002~2014年间1766例单发肝细胞癌肝移植受者的临床数据，利用Kaplan-Meier法分别比较超出“米兰标准”但符合“UCSF标准”（直径5.1~6.5cm，UCSF组）及超出“UCSF标准”但符合“上海复旦标准”患者（直径6.6~9.0cm，上海组）与符合“米兰标准”患者（直径≤5.0cm，米兰组）肝移植术后的总体生存率（OS）和肝癌相关生存率（LCSS）。COX比例风险模型用于分析影响单发肝癌肝移植受者预后的危险因素。［结果］ 米兰组1686例患者术后1、3、5年OS和LCSS分别为93.1%、82.1%、75.3%和96.9%、90.1%、86.4%。UCSF组55例患者术后1、3、5年OS和LCSS分别为92.5%、76.3%、71.7%和96.3%、87.7%、82.5% 。上海组25例患者术后1、3、5年OS和LCSS分别为91.8%、69.8%、64.8%和95.7%、85.9%、79.8%。Kaplan-Meier生存分析显示UCSF组及上海组与米兰组之间OS和LCSS均无统计学差异（P均>0.05）。此外，单因素及多因素COX回归模型显示年龄、肿瘤分化程度、微血管浸润是影响单发肝癌肝移植受者预后的独立危险因素（P均<0.05）。［结论］ “上海复旦标准”单发肝癌肝移植筛选标准（单发、直径≤9.0cm）可在不降低术后生存率的情况下，有效拓展单发肝癌肝移植受者范围；同时，该标准在西方人群中也具有一定的适用性。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the survival of patients with single hepatocellular carcinoma(HCC) meeting Milan criteria，UCSF criteria or Shanghai criteria after liver transplantation(LT)．［Methods］ A total of 1766 patients with single HCC who underwent LT from 2004 to 2012 were collected from Surveillance，Epidemiology，and End Results(SEER) database，including 1686 patients meeting Milan criteria(tumor size≤5.0cm，Milan group)，55 patients meeting UCSF criteria(tumor size 5.1~6.5cm，UCSF group) and 25 patients meeting Shanghai criteria(tumor size 6.6~9.0cm，Shanghai group). Overall survival(OS) and liver cancer-specific survival(LCSS) were compared among the three groups. COX proportional hazard model was used to evaluate the predictors of OS and LCSS. ［Results］ The 1-，3-，5-year OS and LCSS of the Milan group were 93.1%，82.1%，75.3% and 96.9%，90.1%，86.4%；those of the UCSF group were 92.5%，76.3%，71.7% and 96.3%，87.7%，82.5%；and those of the Shanghai group were 91.8%，69.8%，64.8% and 95.7%，85.9%，79.8%. No significant difference was observed among the three groups in terms of OS and LCSS(all P>0.05). Univariate and multivariate Cox proportional hazards regression model showed that patients’ age，tumor differentiation and microvascular invasion were independent predictors of OS or LCSS(all P<0.05). ［Conclusion］ Shanghai criteria of LT for patients with single HCC(single tumor ≤9.0cm) can bring more patients with single HCC to benefit from liver transplantation without affecting the overall survival rate．And it would be adaptable to western patients with single HCC for LT. |
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