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目的:探讨合并肌少症肝细胞癌患者的临床病理特征及术后预后。方法:回顾性分析2010年3月—2016年6月期间就诊于武汉大学人民医院因肝细胞癌行肝切除术的139例患者的临床病理及随访资料。结果:139例患者中,56例(40.3%)合并肌少症。与非肌少症患者比较,肌少症患者体质量指数与骨骼肌指数明显降低、高TNM分期与微血管浸润比例明显增加(均P<0.05);术后发生感染(14.3%vs.3.6%)、严重并发症(Clavien-Dindo Ⅲ级及以上)(19.6%vs.6.0%)、总并发症(35.7 vs.13.3%)的发生率明显升高(均P<0.05);术后恢复时间(17.35 d vs.11.33 d)明显延长,需要入ICU治疗的患者比例(12.5%vs.2.4%)明显增加(均P<0.05);术后总生存时间明显减少(P<0.05)。Cox比例风险模型结果显示,合并肌少症是影响肝细胞癌患者术后生存的独立危险因素(P=0.001,HR=2.090,95%CI=1.340~3.259)。结论:合并肌少症的肝细胞癌患者术后并发症发率增加、恢复慢,且术后预后不良。
Objective: To investigate the clinicopathological features and postoperative prognosis of patients with hepatocellular carcinoma combined with myopathism. Methods: A retrospective analysis of 139 patients with hepatocellular carcinoma undergoing liver resection at People’s Hospital of Wuhan University from March 2010 to June 2016 was performed. Results: Of the 139 patients, 56 (40.3%) had muscular dystrophy. The body mass index and skeletal muscle index were significantly lower in patients with sarcopenia than in non-sarcoidosis patients (P <0.05). The incidence of postoperative infection was 14.3% vs.3.6% , Severe complications (Clavien-Dindo grade Ⅲ and above) (19.6% vs.6.0%), and total complication (35.7 vs.13.3%) were significantly higher (all P <0.05) 17.35 d vs.11.33 d) was significantly prolonged, and the proportion of patients requiring ICU therapy (12.5% vs.2.4%) was significantly increased (all P <0.05). The total postoperative survival time was significantly decreased (P <0.05). The results of Cox proportional hazards model showed that myxoidosis was an independent risk factor for postoperative survival in patients with hepatocellular carcinoma (P = 0.001, HR = 2.090, 95% CI = 1.340-3.259). Conclusion: The incidence of postoperative complications in patients with hepatocellular carcinoma combined with myosin dysplasia is increased, the recovery is slow, and the postoperative prognosis is poor.