肝细胞癌筛查对早期诊断和总生存率的影响:自身数据

V. V. Petkau, E. Bessonova, A. Tarkhanov, M. V. Kartashov, M. A. Anashkina
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HCC was diagnosed as a result of screening carried out on the basis of the Regional Hepatological Center in 34 patients. 114 patients were referred to the oncological hospital due to the detection of a malignant tumor in liver during examination in cause of complaints. The compared groups of patients did not differ in age and sex composition, in the frequency of smoking, alcohol consumption, drug addiction, viral hepatitis B, obesity, diabetes mellitus, arterial hypertension, oncological heredity, in the distribution of LC by class. Patients with HCC detected at screening had a better general somatic status (p < 0.001), more often had viral hepatitis C (82.4% vs. 35.1%, p < 0.001) and AFP above normal (64.7% vs. 43.0%, p = 0.027).Results. Screening influenced the staging of newly diagnosed patients with HCC. If the proportion of stages B and C according to the Barcelona system remained the same, then stage A accounted for 32.4% versus 12.3% (OR = 3.42; 95% CI 1.37–8.49; p = 0.007). Stage D, on the contrary, was less: 8.8% vs. 36.8% (OR = 0.17; 95% CI 0.05–0.58; p = 0.002). Identification at earlier stages and better general condition of patients influenced the possibilities and results of treatment. In the HCC group after screening more patients received treatment: 88.2% versus 56.1% (OR = 5.86; 95% CI 1.94–17.73; p < 0.001). There was a higher one-year overall survival: 79.4% vs 39.5% (OR = 5.91; 95% CI 2.38–14.73; p < 0.001).Conclusion. 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引用次数: 0

摘要

简介通过改进治疗方法和实施筛查计划进行早期检查,可以延长 HCC 患者的预期寿命。评估高危人群筛查对早期发现 HCC、专业治疗的可能性以及 HCC 患者一年总生存率的影响。回顾性研究了 2022 年在斯维尔德洛夫斯克地区肿瘤中心接受治疗的 148 名 HCC 和肝硬化(LC)患者的临床记录,随访时间超过 12 个月。34名患者在地区肝病中心的筛查中被确诊为HCC。114名患者因主诉检查发现肝脏中存在恶性肿瘤而被转诊至肿瘤医院。两组患者在年龄和性别组成、吸烟频率、饮酒、吸毒、乙型病毒性肝炎、肥胖、糖尿病、动脉高血压、肿瘤遗传以及肝癌等级分布方面均无差异。筛查发现的 HCC 患者一般体质较好(P < 0.001),更常患有丙型病毒性肝炎(82.4% 对 35.1%,P < 0.001)和甲胎蛋白高于正常值(64.7% 对 43.0%,P = 0.027)。筛查对新诊断的 HCC 患者的分期有影响。如果根据巴塞罗那系统进行的 B 期和 C 期比例保持不变,那么 A 期患者占 32.4%,而 C 期患者占 12.3%(OR = 3.42;95% CI 1.37-8.49;p = 0.007)。相反,D 阶段的比例较低:8.8% 对 36.8%(OR = 0.17;95% CI 0.05-0.58;p = 0.002)。在较早阶段进行识别以及患者的一般状况较好,都会影响治疗的可能性和效果。在筛查后的 HCC 组中,更多患者接受了治疗:88.2% 对 56.1%(OR = 5.86;95% CI 1.94-17.73;p < 0.001)。一年总生存率更高:79.4% 对 39.5%(OR = 5.91;95% CI 2.38-14.73;P < 0.001)。对高危人群进行 HCC 筛查可提高早期诊断率,增加患者接受专业抗癌治疗的可能性,并提高一年总生存率。
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Impact of hepatocellular cancer screening on early diagnostics and overall survival: own data
Introduction. An increase in the life expectancy of patients with HCC can be achieved both by improving treatment methods and by implementing early examination through screening programs.Aim. Evaluation of the impact of screening in risk groups on early detection of HCC, on the possibility of specialized treatment, on one-year overall survival of patients with HCC.Materials and methods. The clinical records of 148 patients with HCC and liver cirrhosis (LC) who received medical care at the Sverdlovsk Regional Oncology Center in 2022 with the follow-up period exceeding 12 months were retrospectively studied. HCC was diagnosed as a result of screening carried out on the basis of the Regional Hepatological Center in 34 patients. 114 patients were referred to the oncological hospital due to the detection of a malignant tumor in liver during examination in cause of complaints. The compared groups of patients did not differ in age and sex composition, in the frequency of smoking, alcohol consumption, drug addiction, viral hepatitis B, obesity, diabetes mellitus, arterial hypertension, oncological heredity, in the distribution of LC by class. Patients with HCC detected at screening had a better general somatic status (p < 0.001), more often had viral hepatitis C (82.4% vs. 35.1%, p < 0.001) and AFP above normal (64.7% vs. 43.0%, p = 0.027).Results. Screening influenced the staging of newly diagnosed patients with HCC. If the proportion of stages B and C according to the Barcelona system remained the same, then stage A accounted for 32.4% versus 12.3% (OR = 3.42; 95% CI 1.37–8.49; p = 0.007). Stage D, on the contrary, was less: 8.8% vs. 36.8% (OR = 0.17; 95% CI 0.05–0.58; p = 0.002). Identification at earlier stages and better general condition of patients influenced the possibilities and results of treatment. In the HCC group after screening more patients received treatment: 88.2% versus 56.1% (OR = 5.86; 95% CI 1.94–17.73; p < 0.001). There was a higher one-year overall survival: 79.4% vs 39.5% (OR = 5.91; 95% CI 2.38–14.73; p < 0.001).Conclusion. Screening for HCC in risk groups improves early diagnosis, increases the likelihood of patients receiving specialized anticancer treatment and increases the one-year overall survival rate.
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