| Objective1.Retrospective analysis of the clinicopathological features of hepatocellular carcinoma patients operated on by our medical team within the past 5 years;2.The effect of type 2 diabetes on total survival after hepatocellular carcinoma resection was retrospectively analyzed;3.The effect of type 2 diabetes on tumor-free survival after hepatocellular carcinoma resection was retrospectively analyzed.MethodThe clinical and medical records of patients with hepatocellular carcinoma who received surgical treatment in Shandong Provincial Hospital from December 2013 to December 2017 with clear pathological diagnosis were retrospectively analyzed.Telephone follow-up and outpatient follow-up were conducted according to the contact information of patients registered on the first page of medical record.Univariate and multivariate regression analysis of each variable was conducted by COX,and the risk factors and independent risk factors affecting the total survival period and tumor-free survival time of patients were obtained.Kaplan-meier method was used to plot survival curves for univariate survival analysis.GraphPad Prism 7 was used to draw the survival curve.Results1.Analysis of factors affecting the total survival of 254 patients with hepatocellular carcinomaCOX univariate analysis of the 20 factors included in the study showed that type 2 diabetes mellitus,portal vein carcinoma thrombus,hepatitis cirrhosis,tumor T stage,tumor differentiation,tumor capsule,AFP,CEA,CA125 and CA199 were risk fectors affecting the survival and prognosis of the patients,and all P values<0.05 were statistically significant.Univariate COX regression multivariate analysis showed that portal vein tumor thrombus(p=0.000),type 2 diabetes mellitus(p=0.000),T stage of tumor(p=0.044),and differentiation(p=0.002)were independent risk factors affecting survival and prognosis of patients.The risk ratio of PVTT was 4.898(3.163-7.586)compared with no PVTT.The risk ratio for people with type 2 diabetes was 2.187(1.433-3.336)compared to those without type 2 diabetes.The standard regression coefficients(B)were all positive,indicating that portal vein tumor thrombus and type 2 diabetes mellitus were positively correlated with the prognosis of patients with hepatocellular carcinoma after resection.2.Analysis of influencing factors for tumor-free survival in 254 patients with hepatocellular carcinomaCOX univariate analysis of the 20 factors included in the study showed that type 2 diabetes mellitus,portal vein carcinoma thrombus,hepatitis cirrhosis,drinking history,tumor T stage,tumor differentiation,tumor capsule,and CA125 were risk factors affecting the tumor-free survival of patients,with P values<0.05,which was statistically significant.Univariate COX regression multivariate analysis showed that portal vein tumor thrombus(p=0.000),type 2 diabetes mellitus(p=0.017),history of alcohol consumption(p=0.041),and differentiation(p=0.000)were independent risk factors affecting the tumor-free survival time of patients.The risk ratio of tumor-frees urvival time without portal vein tumor thrombus was 2.828(1.902-4.203)for patients with portal vein tumor thrombus.The risk ratio for tumor-free survival in patients with type 2 diabetes was 1.562(1.084-2.250)compared with patients without type 2 diabetes.The standard regression coefficients(B)were all positive,indicating that PVTT and type 2 diabetes were positively correlated with intrahepatic recurrence and extrahepatic metastasis after hepatocellular carcinoma resection.3.Analysis of factors related to type 2 diabetesUnivariate anova was performed for each clinicopathological factor and found that type 2 diabetes was associated with hepatitis cirrhosis,P<0.05 was significantly different.Conclusion1.Type 2 diabetes is an independent risk factor affecting the overall survival of patients.2.Type 2 diabetes is an independent risk factor affecting the tumor-free survival of patients.3.Patients with type 2 diabetes need more frequent reexamination,and the combination therapy can improve the prognosis of patients.4.In patients with HCC complicated with type 2 diabetes,postoperative blood glucose control and monitoring should be strengthened to reduce insulin resistance,which plays an important role in reducing the recurrence of HCC and improving the prognosis of patients. |
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