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术前体重指数对肝细胞癌合并2型糖尿病患者根治性切除术后预后的预测价值
宗倩妮^1,2,郑龙轶^3*
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(1. 海军军医大学(第二军医大学)国家肝癌科学中心, 上海 200438; 2. 海军军医大学(第二军医大学)第三附属医院生物信号转导实验室, 上海 200438; 3. 海军军医大学(第二军医大学)第一附属医院内分泌科, 上海 200433 ^*通信作者)

摘要:

目的探讨术前BMI对肝细胞癌（HCC）合并2型糖尿病患者根治性切除术后生存预后的影响。方法回顾性分析2013年1月至2014年12月在海军军医大学（第二军医大学）第三附属医院行根治性切除术的140例HCC合并2型糖尿病患者的临床资料。患者术前BMI为18.8～31.8 kg/m²，根据术前BMI分为正常BMI（18.8～24.9 kg/m²）组和较高BMI（25.0～31.8 kg/m²）组。对两组患者的基本临床资料及BMI对预后的影响进行分析。结果 140例患者中，正常BMI组94例（67.1%）、较高BMI组46例（32.9%）。两组患者在年龄、性别、实验室检查指标、病理学参数、抗病毒治疗、糖尿病治疗方式、术后预防性经导管动脉化疗栓塞治疗等方面差异均无统计学意义（P均＞0.05）。较高BMI组的3年总生存率（86.0%）高于正常BMI组（64.8%），两组总生存期差异有统计学意义（P＝0.011）。多因素Cox比例风险回归分析显示，较高BMI是HCC合并2型糖尿病患者根治性切除术后总生存期的独立保护因素（HR＝0.379，95% CI 0.156～0.917，P＝0.031）。结论对于HCC合并2型糖尿病患者，术前BMI较高者总生存期更长。

关键词: 体重指数肝细胞癌 2型糖尿病根治性切除术预后

DOI：10.16781/j.CN31-2187/R.20220685

投稿时间：2022-08-23修订日期：2022-11-19

基金项目:国家自然科学基金(81672831).

Prognostic predictive value of preoperative body mass index in patients with hepatocellular carcinoma complicated with type 2 diabetes mellitus after radical resection

ZONG Qian-ni^1,2,ZHENG Long-yi^3*

(1. National Center for Liver Cancer, The Third Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200438, China;
2. Laboratory of Biological Signal Transduction, The Third Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200438, China;
3. Department of Endocrinology, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
^*Corresponding author)

Abstract:

Objective To investigate the impact of preoperative body mass index (BMI) on the survival and prognosis of patients with hepatocellular carcinoma (HCC) complicated with type 2 diabetes mellitus after radical resection. Methods The clinical data of 140 HCC patients with type 2 diabetes mellitus who underwent radical resection in The Third Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2013 to Dec. 2014 were retrospectively analyzed. These patients were divided into 2 groups based on preoperative BMI (ranged 18.8-31.8 kg/m²): normal-BMI (18.8-24.9 kg/m²) group and high-BMI (25.0-31.8 kg/m²) group. The basic clinical data and prognostic factors of the 2 groups of patients were summarized and analyzed. Results Among the 140 patients, 94 (67.1%) and 46 (32.9%) were in the normal-BMI and high-BMI groups, respectively. There was no significant difference between the 2 groups in age, gender, laboratory examination indicators, pathological parameters, antiviral treatment, diabetes treatment, or postoperative preventive transcatheter arterial chemoembolization (all P＞0.05). The 3-year overall survival rate of the high-BMI group (86.0%) was higher than that of the normal-BMI group (64.8%), and there was a significant difference in the overall survival between the 2 groups (P＝0.011). Multivariate Cox proportional hazard regression analysis showed that high-BMI was an independent protective factor for the overall survival of HCC patients with type 2 diabetes after radical resection (hazard ratio＝0.379, 95% confidence interval 0.156-0.917, P＝0.031). Conclusion HCC patients complicated with type 2 diabetes mellitus with high preoperative BMI have significantly better overall survival.

Key words: body mass index hepatocellular carcinoma type 2 diabetes mellitus radical resection prognosis