PDF(Pubmed)
Abstract：
BACKGROUND: Osteopenia is a well-known risk factor for survival in patients with hepatocellular carcinoma; however, it is unclear whether osteopenia can apply to both genders and how osteopenia is associated with cancer progression. The aim of this study was to elucidate whether osteopenia predicts reduced survival in regression models in both genders and whether osteopenia is associated with the pathological factors associated with reduced survival.
METHODS: This study included 188 consecutive patients who underwent hepatectomy. Bone mineral density was assessed using computed tomography (CT) scan images taken within 3 months before surgery. Non-contrast CT scan images at the level of the 11th thoracic vertebra were used. The cutoff value of osteopenia was calculated using a threshold value of 160 Hounsfield units. Overall survival (OS) curves and recurrence-free survival (RFS) were constructed using the Kaplan-Meier method, as was a log-rank test for survival. The hazard ratio and 95% confidence interval for overall survival were calculated using Cox\'s proportional hazard model.
RESULTS: In the regression analysis, age predicted bone mineral density. The association in females was greater than that in males. The OS and RFS of osteopenia patients were shorter than those for non-osteopenia patients. According to univariate and multivariate analyses, osteopenia was an independent risk factor for OS and RFS. The sole pathological factor associated with osteopenia was microvascular portal vein invasion.
CONCLUSIONS: Models suggest that osteopenia may predict decreased OS and RFS in patients undergoing resection of hepatocellular carcinoma due to the mechanisms mediated via microvascular portal vein invasion.
METHODS: This study included 188 consecutive patients who underwent hepatectomy. Bone mineral density was assessed using computed tomography (CT) scan images taken within 3 months before surgery. Non-contrast CT scan images at the level of the 11th thoracic vertebra were used. The cutoff value of osteopenia was calculated using a threshold value of 160 Hounsfield units. Overall survival (OS) curves and recurrence-free survival (RFS) were constructed using the Kaplan-Meier method, as was a log-rank test for survival. The hazard ratio and 95% confidence interval for overall survival were calculated using Cox\'s proportional hazard model.
RESULTS: In the regression analysis, age predicted bone mineral density. The association in females was greater than that in males. The OS and RFS of osteopenia patients were shorter than those for non-osteopenia patients. According to univariate and multivariate analyses, osteopenia was an independent risk factor for OS and RFS. The sole pathological factor associated with osteopenia was microvascular portal vein invasion.
CONCLUSIONS: Models suggest that osteopenia may predict decreased OS and RFS in patients undergoing resection of hepatocellular carcinoma due to the mechanisms mediated via microvascular portal vein invasion.
摘要：
背景：骨质减少是肝细胞癌患者生存的一个众所周知的危险因素；然而，目前尚不清楚骨量减少是否适用于两种性别,以及骨量减少与癌症进展的关系.这项研究的目的是阐明在两种性别的回归模型中，骨量减少是否预示着生存率降低，以及骨量减少是否与生存率降低相关的病理因素有关。
方法：本研究包括188例连续肝切除术患者。使用手术前3个月内拍摄的计算机断层扫描（CT）扫描图像评估骨矿物质密度。使用第11胸椎水平的非对比CT扫描图像。使用160Hounsfield单位的阈值计算骨质减少的截断值。使用Kaplan-Meier方法构建总生存期（OS）曲线和无复发生存期（RFS），生存的对数秩检验也是如此。使用Cox比例风险模型计算总生存期的风险比和95%置信区间。
结果：在回归分析中，年龄预测骨密度。女性的关联大于男性。骨量减少患者的OS和RFS短于非骨量减少患者。根据单变量和多变量分析，骨量减少是OS和RFS的独立危险因素。与骨量减少相关的唯一病理因素是微血管门静脉侵犯。
结论：模型表明，骨量减少可能预测肝细胞癌切除患者的OS和RFS降低，这是由于微血管门静脉浸润介导的机制。
方法：本研究包括188例连续肝切除术患者。使用手术前3个月内拍摄的计算机断层扫描（CT）扫描图像评估骨矿物质密度。使用第11胸椎水平的非对比CT扫描图像。使用160Hounsfield单位的阈值计算骨质减少的截断值。使用Kaplan-Meier方法构建总生存期（OS）曲线和无复发生存期（RFS），生存的对数秩检验也是如此。使用Cox比例风险模型计算总生存期的风险比和95%置信区间。
结果：在回归分析中，年龄预测骨密度。女性的关联大于男性。骨量减少患者的OS和RFS短于非骨量减少患者。根据单变量和多变量分析，骨量减少是OS和RFS的独立危险因素。与骨量减少相关的唯一病理因素是微血管门静脉侵犯。
结论：模型表明，骨量减少可能预测肝细胞癌切除患者的OS和RFS降低，这是由于微血管门静脉浸润介导的机制。
