| Objective:Through research and analysis of the independent prognostic factors of patients with hepatocellular carcinoma,at the same time,the prognostic evaluation ability of BCLC and CNLC liver cancer staging systems and the value of guiding treatment are compared,so as to provide a theoretical basis when choosing clinical treatment strategies.Methods:1.The 100 cases of HCC were collected who were admitted to the Third Department of Hepatobiliary and Biliary Diseases of the Second Affiliated Hospital of Kunming Medical University from June 2014 to December 2016 and have complete follow-up records.The follow-up period ends on December 31,2020.Summarize and use the Kaplan-Meier method and Log-rank method to perform univariate analysis of various indicators to screen the initial prognostic factors,and perform COX regression analysis on the above factors to obtain independent prognostic factors.All cases were clinically staged according to the BCLC and CNLC staging systems,and the ROC curve was used to perform a single trend analysis on the two staging systems to compare their prognostic assessment capabilities.The two stages of treatment were divided into different groups,the Kaplan-Meier method was used to draw the survival curve,and the Log-rank method was used to compare the value of each stage to guide treatment.2.Analyze the data of 100 patients with liver cancer who underwent surgical treatment for the first time.They were staged according to BCLC and CNLC,survival curves were drawn by Kaplan-Meier method,and differences in survival curves were tested by Log-rank method to evaluate the effects of each stage on treatment methods.Guiding value,so as to clarify the scope of application of liver resection.Results:1.As of December 31,2020,a total of 80 patients died and 20 patients survived.The median survival time was 25.9±1.67 months,and the 1-year and 3-year survival rates were 96.0±2.0%and 19.9±4.3%,respectively.COX regression analysis indicated that the etiology(hepatitis B,portal hypertension),tumor diameter,number of tumors,and Child-pugh score were independent prognostic factors for patients with primary liver cancer.The comparison between Kaplan-Meier survival curve and Log-rank method showed that the two staging systems were both related to the patient’s prognosis.The later the staging system,the worse the prognosis(both P values<0.005).Using the COX proportional hazard model,the order of the contribution of the prediction model is:CNLC>BCLC.Compared with BCLC staging,CNLC staging has no obvious advantages in discriminative power and single trend.2.There is no obvious difference between the two stagings for the first-time diagnosis of patients,whether they accept surgical treatment,and both can be used as a staging method to guide surgical treatment.Conclusion:①CNLC has better prognostic assessment capabilities than BCLC;②BCLC treatment recommendations are not fully applicable to the treatment of HCC in my country,and the scope of application of hepatectomy is too strict.For some BCLC stage A or even some B stage patients,surgical treatment can also be considered;③BCLC Both the CNLC staging system and the CNLC staging system are used to evaluate the prognosis and guide the treatment.The CNLC staging system is a staging system for liver cancer in China based on the specific national conditions and practice accumulation of China,based on the general condition of the patient,the condition of liver tumors and the liver function.The program is better than the BCLC staging to a certain extent,but still needs more large samples of clinical verification. |
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