Study On The Prognostic Risk Factors Of Primary Liver Cancer And Their Correlation With TCM Syndrome Element

Objective: Through retrospective study of clinical data of patients with Primary hepatic carcinoma,to explore the risk factors affecting the prognosis of patients with Primary hepatic carcinoma and the relationship of the risk factors with baseline TCM syndrome elements,so as to provide effective evidence-based basis for the diagnosis and treatment of Primary hepatic carcinoma.Methods: According to the diagnosis,inclusion and exclusion criteria,a total of 88 patients with Primary hepatic carcinoma admitted to the hepatology ward of the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2013 to December 2017 were collected.The basic information,clinical data,tumor imaging data,and laboratory indicators of the patients included in the study were collected and uniformly collected into an EXCEL sheet to analyze the overall general conditions and characteristics of the patients included in the study.Secondly,the death of patients with Primary hepatic carcinoma was used as the outcome event for survival analysis,and the factors with P<0.05 were selected for multivariate COX proportional hazards regression analysis after univariate analysis(Kaplan-Meier method)to explore the prognostic factors of Primary hepatic carcinoma.And then,with the help of the TCM health status identification system,referring to the syndrome terms related to this study in Syndrome Element Syndrome Differentiation Science compiled by Professor Zhu Wenfeng,the Symptoms and signs of 88 patients included in this study was input into the system to determine the disease location and the disease nature of the patients,and the main syndrome elements of patients with Primary hepatic carcinoma were determined according to the syndrome element integral and threshold method.Finally,chi-square test was used to analyze the correlation between the syndrome factors and the prognostic risk factors of patients with primary liver cancer.Results: 1.Univariate analysis showed that NRS score,ECOG score,drinking history,viral hepatitis,baseline complications,treatment measures(local treatment),Child-pugh score,BCLC stage,tumor number,type,PTVV status,extrahepatic metastasis,AFP,ALB,and APRI were the prognostic factors of patients with Primary hepatic carcinoma Factors.2.Multivariate COX proportional hazards regression analysis showed that NRS score,combined with viral hepatitis,BCLC stage,extrahepatic metastasis,and AFP were independent factors affecting OS of patients with primary liver cancer.NRS score≥3,combined with viral hepatitis,advanced BCLC stage,extrahepatic metastasis and AFP>400ng/ml were independent risk factors for the prognosis of patients with primary liver cancer.3.In this study,a total of 45 syndrome factors for patients with Primary hepatic carcinoma were extracted,including 17 syndrome elements of disease location and 28 syndrome factors of disease nature.Among the main diagnostic factors,the disease-location syndrome elements included liver,spleen and gallbladder,and the disease-nature syndrome elements included dampness,qi stagnation,blood stasis and heat.4.The correlation analysis between the main syndrome elements and prognostic risk factors showed that damp,heat and qi stagnation syndrome factors had certain correlation with NRS2002,with or without viral hepatitis and BCLC stage respectively.patients with nutritional risk(NRS score ≥3)were prone to damp syndrome elements,Patients without viral hepatitis are more likely to have heat syndrome factors and patients with advanced BCLC stage were prone to qi stagnation syndrome elements.Conclusion: 1.NRS score ≥3,combined with viral hepatitis,advanced BCLC stage,extrahepatic metastasis,and AFP>400ng/ml were independent risk factors for the prognosis of patients with primary liver cancer.2.The main disease location of Primary hepatic carcinoma were liver,spleen and gallbladder,and the main syndrome elements of disease nature were dampness,qi stagnation,blood stasis and heat.3.damp,heat and qi stagnation syndrome factors had certain correlation with NRS2002,with or without viral hepatitis and BCLC stage respectively.patients with nutritional risk(NRS score ≥3)were prone to damp syndrome elements,Patients without viral hepatitis are more likely to have heat syndrome factors and patients with advanced BCLC stage were prone to qi stagnation syndrome elements.