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目的探讨建立肝癌根治术后早期肺转移临床因素及CXCR7蛋白数学预测模型。方法收集根治性切除279例患者的肝癌组织、癌旁组织标本及14例正常肝组织构建组织芯片,利用免疫组织化学方法检测CXCR7蛋白在肝癌组织、癌旁组织及正常肝脏组织中的表达情况;回顾性分析279例患者的临床资料,以10项相关的临床病理因素及肝癌细胞中CXCR7蛋白表达情况进行单因素分析,筛选相关影响因素,并进行多因素分析及建立术后肺转移的预测模型。结果术后1年肺转移发生率为12.9%(36/279)。单因素分析提示肺转移组和无肺转移组在CXCR7蛋白表达、性别、肿瘤大小、术前AFP、镜下脉管癌栓方面相比较有显著性差异。多因素分析提示术后发生肺转移的独立判断因素为CXCR7蛋白阳性表达、肿瘤大小。结论随着肿瘤直径增大、CXCR7蛋白阳性表达,患者术后早期肺转移可能性较大。本预测数学模型P=Y/(1+Y),Y=EXP(-6.676+肿瘤大小的B值+CXCR7蛋白表达的B值)具有较高的预测准确率。
Objective To investigate the clinical factors of early lung metastasis and the prediction model of CXCR7 protein after radical operation of liver cancer. Methods 279 cases of hepatocellular carcinoma tissues, adjacent non-cancerous tissues and 14 cases of normal liver tissue were excised. The expression of CXCR7 protein in hepatocellular carcinoma tissues, paracancerous tissues and normal liver tissues were detected by immunohistochemistry. The clinical data of 279 patients were retrospectively analyzed. Ten related clinical and pathological factors and the expression of CXCR7 protein in hepatocellular carcinoma cells were analyzed by univariate analysis. The influencing factors were screened and multivariate analysis was used to establish the predictive model of postoperative lung metastasis . Results The incidence of lung metastasis at 1 year after operation was 12.9% (36/279). Univariate analysis showed that CXCR7 protein expression, gender, tumor size, preoperative AFP, microscopic vascular thrombosis were significantly different between lung metastasis group and non-lung metastasis group. Multivariate analysis showed that the independent prognostic factors of lung metastasis were CXCR7 protein positive expression and tumor size. Conclusion With the increase of tumor diameter, the expression of CXCR7 protein is positive, and the patients are likely to have early lung metastasis. The predictive mathematical model has a high prediction accuracy with P = Y / (1 + Y), Y = EXP (-6.676 + tumor size B + CXCR7 protein expression B).