肝细胞癌合并糖尿病患者的临床病理特征和预后因素
Clinicopathologic characteristics and prognostic factors for hepatocellular carcinoma patients with diabetes mellitus

目的 ·分析可行根治性肝癌切除的乙肝病毒相关性肝癌合并糖尿病患者临床病理特征及其预后因素。方法 ·回顾性分析2000年1月至2013年12月南昌大学第一附属医院收治的250例可行根治性肝癌切除的乙肝病毒相关性肝癌合并糖尿病患者的临床资料，对患者的基本临床资料和预后因素进行总结分析。结果 ·该组患者男性230例（92.0%），女性20例（8.0%），平均年龄为（53.15±8.73）岁，术前糖尿病病程中值为36个月，糖尿病病程大于5年的患者所占比例为42.0%（105/250），病理类型以Ⅲ级肝细胞癌为主，占65.6%。多因素分析显示肿瘤数量、血红蛋白水平和复发后治疗是合并糖尿病的乙肝病毒相关性肝癌患者的预后因素。结论 ·此类型肝癌多见于有慢性乙型肝炎病史、糖尿病病程大于3年、超重或肥胖的男性肝硬化患者，应该加强对有以上危险因素患者的监测，肝癌复发后综合治疗有助于改善患者的预后。
： Objective · To analyze the clinicopathologic characteristics and prognostic factors for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients with diabetes mellitus (DM) receiving radical resection. Methods · Clinical data of 250 HCC patients with DM receiving radical resection in the First Affiliated Hospital of Nanchang University from January 2000 to December 2013 were retrospectively analyzed. Basic clinical data and prognostic factors were summarized and analyzed. Results · 230 male patients (92.0%) and 20 female patients (8.0%) were enrolled with an average age of (53.15±8.73) years. The preoperative median course of DM was 36 months and there were 42.0% (105/250) of patients with DM for more than 5 years. Edmondson grade III was the main pathological type of HCC, accounting for 65.6%. The multivariate analysis revealed that the number of tumors, hemoglobin level, and treatment after recurrence were prognostic factors for HBV-related HCC patients with DM. Conclusion · This kind of HCC frequently occurs in overweight or obese male liver cirrhosis patients with a chronic hepatitis B history and a DM course of more than 3 years. Monitoring should be enhanced for these patients. The comprehensive treatment after recurrence is helpful for improving their prognosis