Prognostic factors of hepatocellular carcinoma with diabetes mellitus treated with transarterial chemoembolization

doi:10.3877/cma.j.issn.2095-5782.2015.01.004

Abstract

Abstract:

Objective

To evaluate the effect and prognostic factors of 145 cases of HCC patients with diabetes mellitus (DM) treated with TACE.

Methods

A retrospective analysis about the effect and prognostic factors of TACE was conducted on 145 cases of HCC patients with DM. The survival rates were calculated using the Kaplan-Meier method. The log-rank method was used for univariate analysis, and the Cox regression model was used for multivariate analysis.

Results

There was no marked difference the 2 groups patients in postoperative overall survival (P>0.05). There was significant difference between the patients HCC with DM and those without DM in distant metastasis (P<0.05). The hierarchical analysis results show: DM group comparison between groups, Compared with fasting plasma glucose≥8 mmol/L HCC patients, patients with fasting plasma glucose < 8 mmol/L status, Statistically significant (P<0.001) , The median survival time 15.0 (95% CI 13.648-16.352) and 30.0 (95% CI 24.979-35.021) , respectively. Multivariate analysis indicated fasting blood glucose level, tumor size > 8 cm, ECOG score, BCLC grade and PVTT were independent prognostic factors.

Conclusions

Inadequate maintenance of blood glucose in diabetic patients is a significant risk factor for metastasis of HCC and for poor survival after curative TACE therapy.

Key words: Carcinoma, hepatocellular, Transarterial chemoembolization, Diabetes mellitus, Prognosis

Zhongfei Chang, Feng Duan, Hongmei Sun, Maoqiang Wang. Prognostic factors of hepatocellular carcinoma with diabetes mellitus treated with transarterial chemoembolization[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2015, 03(01): 13-17.

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References 18

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影响因素	DM组n=145	非DM组n=168	χ²	P值
年龄(岁)	?	?	1.042	0.154
≥60	60	59	?	?
<60	85	109	?	?
性别	?	?	0.741	0.195
男	126	139	?	?
女	19	29	?	?
空腹血糖（mmol/L）	11.3±3.9	5.3±0.9	?	0.000
肝硬化	?	?	2.078	0.075
有	99	129	?	?
无	46	39	?	?
Child分级	?	?	0.253	0.308
A	119	133	?	?
B	26	35	?	?
ECOG评分	?	?	0.055	0.406
0～1分	107	127	?	?
≥2分	38	41	?	?
肝内肿瘤大小	?	?	1.766	0.091
≥8 cm	35	43	?	?
<8 cm	110	125	?	?
肿瘤数目	?	?	1.100	0.147
单发	83	112	?	?
多发	62	56	?	?
门脉癌栓	?	?	0.313	0.289
有	24	33	?	?
无	121	135	?	?
BCLC分期	?	?	1.523	0.467
A	39	37	?	?
B	82	96	?	?
C	24	35	?	?
血清AFP（ng/ml）	?	?	0.057	0.406
≥20	102	117	?	?
<20	43	51	?	?

影响因素	DM组n=145	非DM组n=168	χ²	P值
年龄(岁)	?	?	1.042	0.154
≥60	60	59	?	?
<60	85	109	?	?
性别	?	?	0.741	0.195
男	126	139	?	?
女	19	29	?	?
空腹血糖（mmol/L）	11.3±3.9	5.3±0.9	?	0.000
肝硬化	?	?	2.078	0.075
有	99	129	?	?
无	46	39	?	?
Child分级	?	?	0.253	0.308
A	119	133	?	?
B	26	35	?	?
ECOG评分	?	?	0.055	0.406
0～1分	107	127	?	?
≥2分	38	41	?	?
肝内肿瘤大小	?	?	1.766	0.091
≥8 cm	35	43	?	?
<8 cm	110	125	?	?
肿瘤数目	?	?	1.100	0.147
单发	83	112	?	?
多发	62	56	?	?
门脉癌栓	?	?	0.313	0.289
有	24	33	?	?
无	121	135	?	?
BCLC分期	?	?	1.523	0.467
A	39	37	?	?
B	82	96	?	?
C	24	35	?	?
血清AFP（ng/ml）	?	?	0.057	0.406
≥20	102	117	?	?
<20	43	51	?	?

因素	非高血糖组（n=98）（<8.0 mmol/L）	高血糖组（n=47）（≥8.0 mmol/L）	P值
性别（男/女）	84/14	42/5	0.373
年龄（岁）	60±9.6	55±8.00	0.006
血糖水平（mmol/L）	6.39±1.25	10.56±2.30	<0.001
诊断糖尿病时间（年）	6.73±5.28	6.96±5.07	0.810
白蛋白（g/L）	37.94±4.91	37.65±5.92	0.764
AFP（ng/ml）	6673.75±41242.94	4230.72±7507.79	0.701
肿瘤大小（cm）	6.46±3.12	7.52±2.86	0.052
肿瘤数目（单发/多发）	59/39	25/22	0.267

因素	非高血糖组（n=98）（<8.0 mmol/L）	高血糖组（n=47）（≥8.0 mmol/L）	P值
性别（男/女）	84/14	42/5	0.373
年龄（岁）	60±9.6	55±8.00	0.006
血糖水平（mmol/L）	6.39±1.25	10.56±2.30	<0.001
诊断糖尿病时间（年）	6.73±5.28	6.96±5.07	0.810
白蛋白（g/L）	37.94±4.91	37.65±5.92	0.764
AFP（ng/ml）	6673.75±41242.94	4230.72±7507.79	0.701
肿瘤大小（cm）	6.46±3.12	7.52±2.86	0.052
肿瘤数目（单发/多发）	59/39	25/22	0.267

因素	Wald	P值	Exp（95.0%CI）
肝内肿瘤大小	10.577	0.001	2.313 (1.396～3.835)
ECOG评分	8.219	0.004	1.982 (1.242～3.165)
BCLC分期	24.597	0.000	2.549 (1.761～3.690)
血糖水平	6.930	0.008	1.960 (1.188～3.235)
门脉癌栓	4.450	0.035	1.942 (1.048～3.598)

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