APRI值与伴HBsAg~+结直肠癌患者同时性肝转移的相关性分析
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摘要
目的评价天冬氨酸转氨酶/血小板比值指数(aspartate transaminase and platelet ratio,APRI)与伴乙肝表面抗原阳性(HBs Ag~+)结直肠癌患者同时性肝转移之间的相关性。方法回顾性分析青岛大学附属医院和山东省肿瘤医院2010年1月至2016年1月收治的214例伴有HBs Ag~+初诊结直肠癌患者的完整病历资料。按是否发生同时性肝转移将214例患者分成两组,syn CRLM~+组30例(同时性肝转移组)和syn CRLM-组184例(无同时性肝转移组),分析APRI值与同时性肝转移的相关性。按APRI值将患者分成两组,APRI高水平组(APRI>0.5)和APRI低水平组(APRI≤0.5),比较两组同时性肝转移率。结果 syn CRLM~+组APRI值低于syn CRLM-组,差异有统计学意义(P<0.05),两组患者性别、年龄、分化程度等差异均无统计学意义(P>0.05)。APRI高水平组同时性肝转移率低于APRI低水平组,差异有统计学意义(P<0.05)。结论伴HBs Ag~+的结直肠癌患者中,高水平APRI者发生同时性肝转移的概率小于低水平APRI者。
Objective To evaluate the association between aminotransferase-to-platelet ratio index(APRI) and synchronous liver metastasis in patients with colorectal cancer with HBs Ag~+. Methods The complete medical records of 214 patients with HBs Ag~+newly diagnosed colorectal cancer admitted to the Affiliated Hospital of Qingdao University and Shandong Cancer Hospital from January of 2010 to January of 2016 were retrospectively analyzed. Patients were divided into the syn CRLM~+group(simultaneous liver metastasis group,30 cases) and the syn CRLM-group( no concurrent liver metastasis group,180 cases) according to whether concurrent liver metastases occurred. The APRI and rate of synchronous liver metastases were analyzed. Patients were divided into APRI high-level group( APRI > 0. 5) and APRI low-level group( APRI≤0. 5) according to APRI values,and the rates of synchronous liver metastases were analyzed between two groups. Results The APRI value of syn CRLM~+group was lower than that of syn CRLM-group,the difference was statistically significant( P < 0. 05). There was no significant difference in gender,age and differentiation between two groups( P > 0. 05). The rate of synchronous liver metastases in the APRI high-level group was lower than that in the APRI-low group,and the difference was statistically significant( P < 0. 05).Conclusion Among colorectal cancer patients with HBs Ag~+,the probability of concurrent liver metastasis in patients with high-level APRI is lower than that in patients with low-level APRI.
Objective To evaluate the association between aminotransferase-to-platelet ratio index(APRI) and synchronous liver metastasis in patients with colorectal cancer with HBs Ag~+. Methods The complete medical records of 214 patients with HBs Ag~+newly diagnosed colorectal cancer admitted to the Affiliated Hospital of Qingdao University and Shandong Cancer Hospital from January of 2010 to January of 2016 were retrospectively analyzed. Patients were divided into the syn CRLM~+group(simultaneous liver metastasis group,30 cases) and the syn CRLM-group( no concurrent liver metastasis group,180 cases) according to whether concurrent liver metastases occurred. The APRI and rate of synchronous liver metastases were analyzed. Patients were divided into APRI high-level group( APRI > 0. 5) and APRI low-level group( APRI≤0. 5) according to APRI values,and the rates of synchronous liver metastases were analyzed between two groups. Results The APRI value of syn CRLM~+group was lower than that of syn CRLM-group,the difference was statistically significant( P < 0. 05). There was no significant difference in gender,age and differentiation between two groups( P > 0. 05). The rate of synchronous liver metastases in the APRI high-level group was lower than that in the APRI-low group,and the difference was statistically significant( P < 0. 05).Conclusion Among colorectal cancer patients with HBs Ag~+,the probability of concurrent liver metastasis in patients with high-level APRI is lower than that in patients with low-level APRI.
引文
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[2]Eichler K,Dufas T,Hammerstingl R,et al.Hepatic Arterial Infusion with Irinotecan in Patients with Liver Metastases of Colorectal Cancer:Results of an Extended Phase I Study[J].Chemotherapy,2013,59(1):66-73.
[3]许剑民,任黎.结直肠癌肝转移诊断和综合治疗指南(V2016)[J].中华胃肠外科杂志,2016,19(7):721-730.
[4]Utsunomiya T,Saitsu H,Saku M,et al.Rare occurrence of colorectal cancer metastasis in livers infected with hepatitis B or C virus[J].Am J Surg,1999,177(4):279-281.
[5]Song E,Chen J,Ouyang N,et al.Kupffer cells of cirrhotic rat livers sensitize colon cancer cells to Fas-mediated apoptosis[J].Br J Cancer,2001,84(9):1265-1271.
[6]Li Z H,Fan P P,Li Z C,et al.Association of hepatitis B virus infection with liver metastasis in colorectal cancer:a clinical study[J].Chinese Journal of Cancer Prevention and Treatment,2014,21(23):1862-1864.
[7]Wai C T,Greenson J K,Fontana R J,et al.A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C[J].Hepatology,2003,38(2):518.
[8]Li Q,Li W,Huang Y,et al.The gamma-glutamyl transpeptidase-toplatelet ratio predicts liver fibrosis and cirrhosis in HBe Ag‐positive chronic HBV infection patients with high HBV DNA and normal or mildly elevated alanine transaminase levels in China[J].J Viral Hepat,2016,23(11):912-919.
[9]Xiao G,Yang J,Yan L.Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection:A systemic review and meta-analysis[J].Hepatology,2015,61(1):292-302.
[10]Chiou W Y,Chang C M,Tseng K C,et al.Effect of liver cirrhosis on metastasis in colorectal cancer patients:a nationwide populationbased cohort study[J].Jpn J Clin Oncol,2014,45(2):160-168.