Clinical Curative Effect of Anatomic Resection on Primary Liver Cancer and Logistic Regression Analysis of Prognostic Influencing Factors
FEI Hai-lin,CHEN Ping,FANG
Chao Lu' an Hospital of Traditional Chinese Medicine, Anhui Lu' an 237006, China
Abstract:
Objective To explore the clinical curative effect of anatomic resection (AR) on primary liver cancer (PLC) and logistic regression analysis of prognostic influencing factors. Methods A total of 258 PLC patients who were admitted to the hospital between January 2014 and January 2018 were divided into anatomic group and non-anatomic group by random number table method, 129 cases in each group. The anatomic group underwent AR, while non-anatomic group underwent non-anatomic resection (NAR). Before surgery and at the 7th day after surgery, liver function indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL)] in both groups were detected. The operation time, intraoperative blood loss, intraoperative blood transfusion and hospitalization time in both groups were recorded. The patients were followed up for 2 years. The poor prognosis was statistically analyzed. The influencing factors that might cause poor prognosis in anatomic group were collected. The influencing factors of prognosis were analyzed by multivariate logistic regression analysis. Results At the 7th day after surgery, serum AST, ALT and TBIL in anatomic group were (32.59±9.57) IU/L, (53.25±17.34) IU/L and(18.57±5.22) μmol/, which significantly lower than those in non-anatomic group [(62.75±20.96) IU/L,(105.46± 34.81) IU/L, (21.44± 6.83) μmol/L] (P<0.05). According to statistics, poor prognosis rate within 2 years in anatomic group was significantly lower than that in non-anatomic group (34.1% vs 46.67%) (P<0.05). The operation time in anatomic group was significantly longer than that in non-anatomic group [(254.7±47.1) min vs (175.6±31.4) min], while intraoperative blood loss, intraoperative blood transfusion and hospitalization time were signi?cantly less than those in non-anatomic group [(452.9±70.6) mL, (276.3±58.4) mL, (13.3±2.6) d vs (616.4±83.5) mL, (515.7±85.6) mL, (14.5±2.8) d (P<0.05). The results of logistic regression analysis showed that age older than 65 years old, tumor size larger than 6 cm, portal vein in?ltration, cirrhosis and hepatitis B virus (HBV) were independent risk factors of prognosis (P<0.05). Conclusion The curative effect of AR is signi?cant on PLC, which can reduce intraoperative blood loss, shorten hospitalization time. There are effects of age, tumor size, portal vein in?ltration, cirrhosis and HBV on prognosis of PLC patients undergoing AR.
