本文選題：肝細(xì)胞癌 + 骨轉(zhuǎn)移��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析肝細(xì)胞癌骨轉(zhuǎn)移病人的一般人口學(xué)、臨床以及病理資料,探討肝細(xì)胞癌骨轉(zhuǎn)移發(fā)生的危險(xiǎn)因素。方法:本次研究于2014年1月到2016年6月在山西省腫瘤醫(yī)院收集肝細(xì)胞癌患者共209例。明確診斷為肝細(xì)胞癌原發(fā)病灶骨轉(zhuǎn)移患者作為病例組,共110人;肝細(xì)胞癌非骨轉(zhuǎn)移病例99例為對(duì)照組。將可能影響肝細(xì)胞癌病人發(fā)生骨轉(zhuǎn)移的相關(guān)因素進(jìn)行分析。同時(shí)使用logistic回歸分析模型進(jìn)行多因素校正分析。結(jié)果:對(duì)相關(guān)影響因素進(jìn)行分析提示,患者性別、婚姻狀況、職業(yè)、文化程度、常住地、體重指數(shù)、口味、經(jīng)常飲酒和飲茶、性格、婚姻滿意程度、親朋好友關(guān)系、是否經(jīng)常發(fā)脾氣、遇事態(tài)度、生活壓力、經(jīng)歷重大事件、Tbil、ALB、ALT、ALP、GGT、HBV是否感染、HBV DNA水平、鏡下脈管癌栓、肝門阻斷時(shí)間和否發(fā)生肝硬化與肝細(xì)胞癌骨轉(zhuǎn)移發(fā)生無關(guān)。而年齡、吸煙情況、血清AFP水平、γ-GT水平、腫瘤個(gè)數(shù)、腫瘤最大直徑、癌細(xì)胞存在微血管侵犯、腫瘤分化程度、原發(fā)病灶控制情況、KPS評(píng)分、SUV水平和放療后SUV下降情況是影響肝細(xì)胞癌骨轉(zhuǎn)移發(fā)生的相關(guān)危險(xiǎn)因素。logistic回歸分析模型進(jìn)行多因素校正分析顯示,腫瘤個(gè)數(shù)、腫瘤分化程度、KPS評(píng)級(jí)、原發(fā)病灶控制情況和血清γ-GT水平是肝細(xì)胞癌骨轉(zhuǎn)移發(fā)生的獨(dú)立危險(xiǎn)因素。結(jié)論:1.年齡、吸煙與否、血清AFP水平、γ-GT水平、腫瘤情況、腫瘤分化程度、腫瘤最大直徑、肝癌細(xì)胞是否存在微血管侵犯、原發(fā)病灶控制情況好壞、KPS評(píng)分、SUV和放療后SUV下降程度與肝細(xì)胞癌患者是否發(fā)生骨轉(zhuǎn)移有關(guān)。2.腫瘤多發(fā)、腫瘤分化程度差、原發(fā)病灶控制情況差以及γ-GT≥150IU/L是肝細(xì)胞癌骨轉(zhuǎn)移的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to analyze the general demographic, clinical and pathological data of patients with bone metastases from hepatocellular carcinoma (HCC), and to explore the risk factors of bone metastasis in hepatocellular carcinoma (HCC). Methods: 209 patients with hepatocellular carcinoma were collected from January 2014 to June 2016 in Shanxi Provincial Cancer Hospital. 110 patients with primary bone metastasis of hepatocellular carcinoma and 99 patients with non-bone metastasis of hepatocellular carcinoma were selected as the case group and the control group respectively. The factors related to bone metastasis in hepatocellular carcinoma patients were analyzed. At the same time, the logistic regression model is used for multivariate calibration analysis. Results: the related factors were analyzed and concluded: sex, marital status, occupation, education, residence, body mass index, taste, frequent drinking and drinking tea, personality, marital satisfaction, family and friends, Whether you often lose your temper, get into trouble, live under pressure, experience major events, or not, whether HBV DNA is infected with ALP GGTV HBV, vascular cancer thrombus under microscope, the time of hepatic hilus occlusion and the occurrence of liver cirrhosis are not related to the occurrence of bone metastasis in hepatocellular carcinoma (HCC). Age, smoking status, serum AFP level, 緯 -GT level, tumor number, tumor maximum diameter, microvascular invasion of cancer cells, tumor differentiation degree, KPS score and SUV decline after radiotherapy were related risk factors of bone metastasis of hepatocellular carcinoma. Logistic regression analysis showed that tumor number and tumor differentiation degree were higher than that of KPS. Primary focus control and serum 緯-GT levels are independent risk factors for bone metastasis in hepatocellular carcinoma. Conclusion 1. Age, smoking or not, serum AFP level, 緯 -GT level, tumor status, tumor differentiation, tumor maximum diameter, microvascular invasion of hepatoma cells, The control of primary foci was correlated with the decrease of SUV and SUV after radiotherapy in patients with hepatocellular carcinoma (HCC). Multiple tumors, poor differentiation, poor control of primary lesions and 緯 -GT 鈮，

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