关键词: 原发性肝癌, 门静脉癌栓, 预后, 预测模型

Abstract: Objective To establish a preoperative prediction model for the prognosis of patients with primary liver cancer and portal vein tumor thrombus. Methods Eight-six cases of primary liver cancer with portal vein tumor thrombus who received the radical resection of liver cancer in combination with section thrombectomy were included as the research objects. Their 2-year survival rates were recorded by followed up. Logistic multivariate analysis was used to obtain the independent factors that were associated with the prognosis of patients with primary liver cancer and portal vein tumor thrombus. These factors were used to establish a preoperative prediction model. Results The 86 patients were followed up for 2 years in which 18 cases died and 68 cases survived, with a 2-years survival rate of 79.07%. By logistic multivariate analysis it was found that Child Pugh liver function grade (OR=1.682, P=0.029), tumor diameter (OR=2.279, P=0.000) and tumor stage (OR=1.231, P=0.006) were the risk factors of poor prognosis in patients with primary liver cancer and portal vein tumor thrombus. Serum albumin (Alb) level was a protective factor for poor prognosis (OR=0.712, P=0.002). The preoperative prediction model was established as the Y=1.682X1+2.279X2+1.231X3-0.712X4 (X1 was Child Pugh liver function grade, X2 was tumor diameter, X3 was tumor stage, X4 was Alb). The receiver operating characteristic curve (ROC) analysis showed that the area under the curve (AUC) of this prediction model was 0.810 (S.E.=0.056, 95%Cl=0.700-0.921,P=0.000) and the best cut off value was 7.500 scores. Conclusion The prognosis of patients with primary liver cancer and portal vein tumor thrombus is co-related with their liver function, Alb level, tumor stage and tumor diameter. The established preoperative prediction model is helpful in evaluating the patients’ prognosis and provide a reference for clinical practice.

Key words: Primary liver cancer, Portal vein tumor thrombus, Prognosis, Predictive mode