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題 名 | The Estimated Glomerular Filtration Rate as a Prognostic Predictor for Hepatocellular Carcinoma=以腎絲球過濾率作為肝癌的一個預後指標 |
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作 者 | 霍德義; 夏振源; 黃怡翔; 邱怡友; 蘇建維; 林漢傑; | 書刊名 | 臺灣消化醫學雜誌 |
卷 期 | 28:1 2011.03[民100.03] |
頁 次 | 頁24-33 |
分類號 | 415.5362 |
關鍵詞 | 腎絲球過濾率; 肝硬化; Child-Turcotte-Pugh; Glomerular filtration rate; Hepatocellular carcinoma; |
語 文 | 英文(English) |
中文摘要 | Background:肝癌病患經常合併有肝硬化及腎功能不足。腎絲球過濾率(eGFR)是一個腎功能的指標。本研究在探討eGFR是否可作爲肝癌病患的長期預後指標。 Methods:eGFR是以MDRD的公式計算而來,共有1,866肝癌病患進入分析。Results:共有452(24%)病患的eGFR<60 ml/min/1.73平方公尺,eGFR和腫瘤總體積無明顯相關,但顯著和肝硬化的Child值有反向相關,在eGFR<25,25-50,50-75和>75 ml/min/1.73平方公尺的病人,他們的Child值分別爲7.3±2.1,6.5±1.9,6.0±1.6及6.0±1.5。在存活分析中發現,eGFR值愈低者,死亡的風險愈高(p值均<0.05)。 |
英文摘要 | Background and Aim: Patients with hepatocellular carcinoma (HCC) often have coexisting cirrhosis which may predispose to renal dysfunction. The estimated glomerular filtration rate (eGFR) is a marker to indicate renal functional reserve. We investigated the feasibility of eGFR in predicting the long-term survival for HCC patients. Methods: The eGFR was calculated using the modification of diet in renal disease formula. A total of 1,866 HCC patients were stratified into 4 groups to determine the long-term outcome according to their baseline eGFRs. Results: A total of 452 (24.2%) patients had renal insufficiency, defined as eGFR < 60 ml/min/1.73m^2, at the time of diagnosis. The eGFR was not significantly associated with total tumor volume, but was significantly and inversely correlated with Child-Turcotte-Pugh (CTP) score. The mean CTP score was 7.3±2.1, 6.5±1.9, 6.0±1.6 and 6.0±1.5 for patients with eGFR of < 25, 25-50, 50-75 and > 75 ml/min/1.73 m^2, respectively (p<0.0001). During a mean follow-up period of 18 months, 776 (42%) patients died. In the survival analysis using adjusted Cox proportional hazards model, the risk ratio of mortality was 1.68 (p=0.02), 1.44 (p=0.001) and 1.18 (p=0.04) for the groups of patients with eGFR of < 25, 25-50 and 50-75 ml/min/1.73 m^2, respectively, in comparison with patients with eGFR > 75 ml/min/1.73 m^2. Conclusions: Renal insufficiency is commonly seen in HCC patients. The eGFR is a feasible prognostic predictor for patients with early to advanced stage HCC. Future clinical studies and cancer staging systems for HCC may include this parameter to stratify the mortality risk. |
本系統中英文摘要資訊取自各篇刊載內容。