分析微波消融与肝切除术对AJCCⅠ期肝细胞癌患者预后影响—基于SEER数据库

doi:10.3969/j.issn.1009-976X.2025.04.001

摘要/Abstract

摘要： 目的通过对SEER数据库中AJCC Ⅰ期肝细胞癌患者不同外科干预策略的预后分析,探讨AJCC Ⅰ期肝细胞癌的最佳处理策略。方法通过SEER数据库获取并筛选2010年1月1日至2015年12月31日期间的AJCC Ⅰ期肝细胞癌患者资料,采用倾向性评分匹配（1∶1最近邻）平衡混杂因素,根据外科干预策略的不同将其分为微波消融组和肝切除术组（各165例）。使用Kaplan-Meier生存分析绘制生存曲线并计算平均生存期,Cox回归分析AJCC Ⅰ期肝细胞癌特异性死亡的影响因素。结果 Kaplan-Meier生存曲线表明,肝切除术组平均生存时间长于微波消融组平均生存时间,肝切除术组特异性死亡率低于微波消融组（P=0.046）。Cox回归析表明,外科干预、分化程度、婚姻状况、年龄是AJCC Ⅰ期肝细胞癌的独立危险因素（均P<0.05）。结论外科干预是AJCC Ⅰ期肝细胞癌患者的独立危险因素之一,行肝切除术的AJCC Ⅰ期肝细胞癌患者特异性死亡风险降低,对AJCC Ⅰ期肝细胞癌患者行肝切除术的预后明显优于行微波消融。

关键词: 肝细胞癌, AJCC Ⅰ期, 微波消融, 肝切除术, 预后, SEER数据库

Abstract: Objective To explore the optimal management strategy for AJCC stage I hepatocellular carcinoma through a prognostic analysis of different surgical intervention strategies for patients in the SEER database. Methods Data of patients with AJCC stage I hepatocellular carcinoma from January 1, 2010, to December 31, 2015, were retrieved and screened from the SEER database. Propensity score matching （1∶1 nearest neighbor） was used to balance confounding factors, dividing them into a microwave ablation group and a hepatectomy group （165 cases each） based on different surgical intervention strategies. Kaplan-Meier survival analysis was used to plot survival curves and calculate the mean survival time. Cox regression analysis was performed to identify the influencing factors of AJCC stage I hepatocellular carcinoma-specific mortality. Results Kaplan-Meier survival curves showed that the mean survival time of the hepatic resection group was longer than that of the microwave ablation group, and the specific mortality rate of the hepatic resection group was lower than that of the microwave ablation group （P=0.046）. Cox regression analysis showed that surgical intervention, degree of differentiation, marital status, and age were independent risk factors for AJCC stage I hepatocellular carcinoma （all P<0.05）. Conclusion Surgical approach is one of the independent risk factors for patients with AJCC stage I hepatocellular carcinoma. Patients with AJCCstage I hepatocellular carcinoma who undergo liver resection have a reduced cancer specific mortality. The prognosis of patients with AJCC stage I hepatocellular carcinoma who undergo liver resection surgery is significantly higher than that of those who undergo microwave ablation surgery.

Key words: hepatocellular carcinoma, AJCC stage I, microwave ablation, hepatectomy, prognosis, SEER database

中图分类号:

R657.3

江川, 刘睿, 蔡波, 蔡泽云. 分析微波消融与肝切除术对AJCCⅠ期肝细胞癌患者预后影响—基于SEER数据库[J]. 岭南现代临床外科, 2025, 25(04): 215-219.

JIANG Chuan, LIU Rui, CAI Bo, CAI Zhe-yun. Microwave ablation and hepatectomy on prognosis in patients with AJCC stage I hepatocellular carcinoma based on the SEER database[J]. Lingnan Modern Clinics In Surgery, 2025, 25(04): 215-219.

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