CD8＋比值对肝癌切除术后复发的预测价值-论文.pdf

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1、·486·中华肝胆外科杂志2014年7月第2O卷第7期ChinJHepatobiliarySurg，Julv2014．Vo1．20，No．7·论著·术前外周血CD4+／CD8+比值对肝癌切除术后复发的预测价值朱耿隆林志东苏永辉周文英陈东张百萌【摘要】目的评价肝癌患者术前外周血CIM／CD8比值对肝癌患者术后复发的预测价值。方法回顾性分析中山大学附属第五医院67例肝癌行肝部分切除患者的临床资料。根据患者术前外周静脉血CD4／CD8比值大小分为低比值组(CIM／CD8比值<1)和高比值组(CD4／CD8比值≥1)。术后应用门诊、电话方式随访至2013年6月。以Cox回归模型对术后复发

2、情况进行相关因素分析。结果单因素分析提示，术前AFP1>400L、肿瘤最大径>5am、肿瘤数目>3个、CIM／CD8<1、血管侵犯及切缘阳性、门静脉癌栓是影响肝癌肝切除术后无瘤生存的危险因素(P<0．05)。Cox回归分析显示术前CIM／CD8<1、肿瘤数目>3个以及门静脉癌栓是肝癌术后复发的独立危险因素(P<0．05)。结论术前CIM／CD8<1是影响肝癌患者术后复发的独立危险因素，对肝癌患者的预后具有预测价值。【关键词】肝细胞癌；T淋巴细胞，CD4／CD8比值；术后复发PreoperativebloodCD4／CD8ratioasanindependentpredictoro

3、fpostoperativerecurrenceafterhepatectomyforhepatocellularcarcinomaZhuGenglong，LinZhidong，SuYonghui，ZhouWenying，ChenDong，ZhangBaimeng．DepartmentofGeneralSurgery，FifthHospitalAfiliatedtoSunYat—senUniversity，Zhuhai519000，ChinaCorrespondingauthor：ZhangBaimeng，Email：bmzhang4l1@163．com【Abstract】0bj

4、ectiveTostudythepredictivevalueofpreoperativebloodcD4／CD8ratioinpostoperativerecurrenceafterhepatectomyforpatientswithhepatocellularcarcinoma．Methodseclini—caldataof67PatientswhounderwenthepatectomyforhepatoceUularcarcinomaatTheFifthHospitalA陆lia．tedtoSunYat-senUniversitywereanalyzedretrospec

5、tively．UsingthepreoperativebloodCIM／CD8raft-O，thesepatientsweredividedinto2groups，theCD4／CD8<1groupandtheCD4／CD8≥1group．Thesepailentswerefollowedupattheoutpatientclinicand／orbytelephonetillJune2013．TheCoxratioriskpatternanalysisWaSusedtodeterminethesignificantriskfactorsoftumorrecurrence．Resu

6、ltsOnuni—variateanalysis，preoperativeAFP≥400L，maximumdiameteroftumor>5cm，numberoftumor>3，CIM／CD8<1，vascularinvasion，positiveresectionmargin，andportalveintumorthrombuswereriskfactorsofpoordisease—freesurvival(P<0．05)．Onmultivariantanalysis，CIM／CD83，andportalveintumorthrombuswe

7、reindependentpredictorsofpoordisease—freesurvivalafterhepatectomyforhepatocellularcarcinoma(P<0．05)．ConclusionsPreoperativeCIM／CD8<1wasanindependentadversepredictorofpoordisease·freesurviva1．Itwasvaluableinpredictingpostoperativerecur-renceof