| 摘要: |
| 目的 探索血小板(PLT)以及PLT源性5-羟色胺(5-HT)对早期肝癌切除患者术后肝功能、术后复发、远期生存率等的影响。方法 采用前瞻性队列研究设计。选取第二军医大学东方肝胆外科医院从2009年1月至12月连续收治的符合Milan标准的297例原发性肝癌切除的患者,收集患者临床资料,用ELISA试剂盒检测患者血清5-HT浓度。定期对患者进行随访,分析肝癌切除术后肝功能不全(LD)、总生存(OS)时间、无瘤生存(RFS)时间的相关危险因素。结果 术后发生LD的患者术前和术后的PLT计数均较术后未发生LD患者低(P<0.001)。血清5-HT浓度与PLT计数呈正相关(r=0.712,P<0.001)。术前低PLT计数 (OR=2.952,95%CI:1.206~7.229, P=0.018)和低血清5-HT浓度 (OR=4.989,95%CI:2.004~12.422, P=0.001)是早期肝癌切除术后LD的独立危险因素。术前低PLT计数 (OR=1.782,95%CI:1.086~2.924, P=0.022)和低血清5-HT浓度 (OR=1.754,95%CI:1.014~3.034, P=0.015) 是OS时间的独立危险因素,但术前PLT计数和血清5-HT浓度高低与RFS时间无明显关系。结论 术前低PLT和低5-HT的早期肝癌切除患者术后围术期预后和远期预后均较差。 |
| 关键词: 肝肿瘤 血小板 血清素 肝功能不全 复发 队列研究 |
| DOI：10.16781/j.0258-879x.2016.06.0683 |
| 投稿时间：2015-08-02修订日期：2015-10-11 |
| 基金项目: |
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| Influences of platelet and platelet-derived 5-hydroxytryptamine on prognosis of early stage hepatocellular carcinoma patients following curative resection: a prospective cohort study |
| FEI Guo-xiong1△,CUI Long-jiu2△,CAO Mei-li1,YANG Yuan3,YU Wei-feng1* |
(1. Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China;
2. Department of Special Treatment Ⅱ, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China;
3. Department of Hepatic Surgery Ⅲ, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
△Co-first authors
*Corresponding author) |
| Abstract: |
| Objective To explore the influences of platelet and platelet-derived 5-hydroxytryptamine (5-HT) on liver function, post-operative recurrence and long-term survival of patients with early stage hepatocellular carcinoma (HCC) following curative resection. Methods Prospective cohort study was employed in this research. A total of 297 consecutive patients who met the Milan criteria and received HCC curative resection from January 2009 to December 2009 in our hospital were selected, and their clinical data were collected. Patients' serum samples were stored at -80℃. Serum 5-HT concentration was detected by ELISA kits. Patients were regularly followed-up to observe their health condition after operation. The influences of PLT and 5-HT on liver dysfunction (LD), overall survival (OS) and recurrence-free survival (RFS) of patients with early stage HCC resection were analyzed via Cox' proportional hazard regression model. Results It was found that the pre- and post-operation PLT counts of patients with post-operation LD were significantly lower than those with normal post-operation liver function (P<0.001). Serum 5-HT concentration was positively correlated with PLT count(r=0.712, P<0.001). Low pre-operative PLT (OR=2.952, 95%CI:1.206-7.229, P=0.018)and low preoperative serum 5-HT concentration (OR=4.989, 95%CI: 2.004-12.422, P=0.001) were the independent risk factors of LD after early stage HCC resection. Low pre-operative PLT (OR=1.782, 95%CI:1.086-2.924, P=0.022) and low pre-operative serum 5-HT concentration (OR=1.754, 95%CI:1.014-3.034, P=0.045) were also the independent risk factors of OS; however, the pre-operative PLT and 5-HT were not the independent risk factors of RFS. Conclusion Early stage HCC patients with low pre-operative 5-HT and PLT tend to have poorer perioperative and long-term outcomes after curative hepatic-resection. |
| Key words: liver neuplasm platelet serotonin hepatic insufficiency recurrence cohort studies |
