检验医学 ›› 2025, Vol. 40 ›› Issue (4): 344-349.DOI: 10.3969/j.issn.1673-8640.2025.04.006

• 肝癌新标志物基础研究和临床应用专题 • 上一篇    下一篇

术前平均血红蛋白浓度预测肝内胆管癌患者术后复发

代靖雯1, 杨烁2, 王冲2(), 孙林2, 顾梅秀2, 鲜敬荣2, 潘柏申2, 王蓓丽2, 张春燕1, 郭玮2   

  1. 1.上海市老年医学中心检验科,上海 201104
    2.复旦大学附属中山医院检验科,上海 200032
  • 收稿日期:2024-07-25 修回日期:2024-12-01 出版日期:2025-04-30 发布日期:2025-05-08
  • 通讯作者: 王 冲,E-mail:wang.chong@zs-hospital.sh.cn
  • 作者简介:代靖雯,女,2001年生,学士,技师,主要从事临床检验工作;杨 烁,女,1991年生,博士,主管技师,主要从事临床检验工作。代靖雯和杨烁对本研究具有同等贡献,并列为第一作者。
  • 基金资助:
    国家自然科学基金面上项目(82172348);上海市“科技创新行动计划”自然科学基金面上项目(23ZR1411100);上海市科学技术委员会启明星培育扬帆专项(22YF1406200)

Role of preoperative mean corpuscular hemoglobin concentration for predicting postoperative recurrence in intrahepatic cholangiocarcinoma patients

DAI Jingwen1, YANG Shuo2, WANG Chong2(), SUN Lin2, GU Meixiu2, XIAN Jingrong2, PAN Baishen2, WANG Beili2, ZHANG Chunyan1, GUO Wei2   

  1. 1. Department of Clinical Laboratory,Shanghai Geriatric Medical Center,Shanghai 201104,China
    2. Department of Clinical Laboratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China
  • Received:2024-07-25 Revised:2024-12-01 Online:2025-04-30 Published:2025-05-08

摘要:

目的 探讨外周血平均血红蛋白浓度(MCHC)在肝内胆管癌(ICC)患者术后复发预测中的作用。方法 选取2018年4月—2022年11月复旦大学附属中山医院首次进行肝切除手术的ICC患者114例,收集其临床资料和实验室检测数据。对患者进行随访。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价MCHC判断ICC患者术后复发的效能并确定最佳临界值。采用Kaplan-Meier生存曲线分析ICC患者术后复发情况。采用Cox回归分析评估ICC患者术后复发的影响因素。结果 114例ICC患者中,有59例发生复发。MCHC判断ICC患者术后复发的最佳临界值为341 g·L-1。MCHC<341 g·L-1组和MCHC≥341 g·L-1组肿瘤数目、美国癌症联合委员会(AJCC)分期差异均有统计学意义(P<0.05),其他临床病理特征差异均无统计学意义(P>0.05)。MCHC≥341 g·L-1组无复发生存率显著高于MCHC<341 g·L-1组(Log-rank χ2=4.304,P=0.038)。Child分级B级、有淋巴转移和MCHC<341 g·L-1为ICC患者肝切除术后复发的独立危险因素[风险比(HR)分别为0.049、2.106、0.521,95%可信区间(CI)分别为0.006~0.426、1.238~3.577、0.290~0.937,P<0.05]。结论 术前MCHC水平与ICC患者预后有关。MCHC水平较低的ICC患者术后复发的可能性较高,预后较差。

关键词: 平均血红蛋白浓度, 复发, 肝内胆管癌, 肝切除术

Abstract:

Objective To evaluate the predictive role of preoperative mean corpuscular hemoglobin concentration(MCHC) in peripheral blood for postoperative recurrence in patients with intrahepatic cholangiocarcinoma(ICC).Methods A retrospective study was conducted on 114 ICC patients who underwent their first hepatectomy at Zhongshan Hospital of Fudan University from April 2018 to November 2022. Comprehensive clinical data and laboratory test results were collected. The patients were followed up. Receiver operating characteristic(ROC) curve analysis was performed to evaluate the predictive performance of MCHC for postoperative recurrence in ICC patients,and its optimal cut-off value was obtained. Kaplan-Meier survival curve was constructed to analyze postoperative recurrence in ICC patients. Cox regression analysis was used to evaluate the independent risk factors for postoperative recurrence in ICC patients.Results During the follow-up period,59 cases experienced postoperative recurrence. The optimal cut-off value of MCHC for postoperative recurrence in ICC patients was 341 g·L-1. There was statistical significance in tumor numbers and American Joint Committee on Cancer(AJCC)staging between MCHC<341 g·L-1 group and MCHC≥341 g·L-1 group(P<0.05),while other clinicopathologic characteristics showed no statistical significance(P>0.05). The recurrence-free survival rate was higher in MCHC≥341 g·L-1 group compared to MCHC<341 g·L-1 group(Log-rank χ2=4.304,P=0.038). Child Grade B,lymphatic metastasis,and MCHC<341 g·L-1 were identified as independent risk factors for postoperative recurrence in ICC patients [hazard ratios(HR) were 0.049,2.106 and 0.521,95% confidence intervals(CI) were 0.006-0.426,1.238-3.577 and 0.290-0.937,respectively,P<0.05].Conclusions Preoperative MCHC is associated with the prognosis of ICC patients. Lower MCHC in ICC patients is associated with increased postoperative recurrence risk and poorer prognosis.

Key words: Mean corpuscular hemoglobin concentration, Recurrence, Intrahepatic cholangiocarcinoma, Hepatectomy

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