Prognostic Factors Of 248 Patients With Primary Liver Cancer With Spleen Deficiency

Objective:Exploring the relationship between various prognosis factors for the patients with spleen deficiency of primary liver cancer and the survival time,so that to evaluate the size of the impact on overall survival.Methods:1. Restrospectively analyzed the patients,spleen deficiency of primary liver cancer, who were treated from september 2012 to november 2014 in the Chief Physician of doctor Wuyu in XiYuan Hospital of China Academy of Chinese Medical Sciences.According to the inclusion and exclusion criteria.there are 248 eligible cases have been brought up.2.26 items may prognostic factors have been screened,there are physical fee tors:gender.age,history of hepatitis B infection, liver cirrhosis history;tumor factors:portal vein tumor thrombus,percentage of tumor size,malignant ascites.the level of AFP,AST,ALT,TBIL,ALB,performance status(PS),liver function Child-pugh classification;4 types of staging system:Okuda stage,CLIP score,BCLC stage and China liver cancer stage;also conclude spleen deficiency syndrome:weak.poor appetite.abdominal distention.diarrhea.nausea and vomiting,gastric stuffy.sallow complexion and loss of weight.3. The first in application of Life Table and Kaplan-Meier(produet-limit method) calculate the total each year Survival Rate and Median Survival Time, produce the Survival Function Diagram by prognostic factors and lifetime, and compare factors of each in Log-rank method of testing.And then apply the COX regression model for single factor analysis and multivariate analysis,and screen on the truly meaningful prognosis of Spleen Deficiency of Primary Liver Cancer.At last,through the regression coefficients B and relative risk Exp(B) to formulate the regression equation and prognostic index(PI) equation.Results:1.Univariate analysis demonstated that 19 prognostic factors of portal vein tumor thrombus.percentage of tumor size.malignant ascites,AST,TBIL,ALB,performance status(PS),liver function Child-pugh classification, Okuda stage,CLIP score.BCLC stage, China liver cancer stage, weak,poor appetite,abdominal distention, nausea and vomiting.gastric stuffy.sallow complexion and loss of weight in the prognosis of Spleen Deficiency of Primary Liver Cancer were significantly significance(P<0.05);while the gender,age,history of hepatitis B infection, liver cirrhosis history, the level of AFP,ALT.diarrhea on the prognosis of Spleen Deficiency of Primary Liver Cancer were non-significant(P>0.05).2.Multivariate analysis showed that China liver cancer stage, poor appetite,abdominal distention is involved in 3 prognostic factors affecting the prognosis of Spleen Deficiency of Primary Liver Cancer meaningful factors,and there was a significant difference in statistics(P<0.05)。 While others such as portal vein tumor thrombus percentage of tumor size, liver function Child-pugh classification, Okuda stage,weak and so on were non-significant(P>0.05).3. Through the regression coefficients B and relative risk Exp(B) of the multivariate analysis results to formulate the regression equation:Y=exp (0.749X18+0.285X20+0.250X21) and prognostic index(PI) equation:PI=0.749X18+0.285X20+0.250X21.Conclusion:Through single factors and multiple factors analysis of 248 eligible cases in Spleen Deficiency of Primary Liver Cancer,this study eventually found that 2 symptoms of spleen deficiency(poor appetite and abdominal distention) and a staging system(China liver cancer stage) may be were the independent risk factors.