中国实用外科杂志

中国实用外科杂志

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槐耳颗粒预防伴有高危复发危险因素肝细胞癌术后复发的临床疗效分析

姜坤元 ，刘子豪，李靖飞，尹大龙   

  1. 中国科学技术大学附属第一医院（安徽省立医院）普通外科，安徽合肥 230001
  • 出版日期:2025-02-01

  • Online:2025-02-01

摘要： 目的    探讨槐耳颗粒预防伴有高危复发风险因素的肝细胞癌病人术后复发的有效性。方法    回顾性分析2019年1月至2022年1月中国科学技术大学附属第一医院（安徽省立医院）经病理学检查结果证实伴有高危复发危险因素（合并侵犯微血管、肿瘤直径≥5 cm、低分化）的118例肝细胞癌病人的临床资料，按术后是否服用槐耳颗粒分为药物组（38例）和对照组（80例）。主要观察指标为术后1年无复发生存率。采用倾向性评分匹配控制潜在的选择偏倚。结果    中位随访时间为13（2~40）个月。倾向性评分匹配前，两组男性、乙肝表面抗原阳性、甲胎蛋白≥400 μg/L及低分化病人比例差异有统计学意义（P＜0.05）。药物组和对照组病人术后1年无复发生存率分别为86.8%和51.2%，差异有统计学意义（P <0.001）。Cox回归分析结果显示术后服用槐耳颗粒是无复发生存率的独立保护因素（HR=0.333，95%CI 0.162~0.686，P=0.003）。倾向性评分匹配后，两组病人基线资料具有较好的一致性，差异均无统计学意义（P＞0.05）。药物组和对照组病人术后1年无复发生存率分别为84.6%和57.7%，差异有统计学意义（P =0.042）。与药物组相比，对照组有更高的肝内多发转移发生率，差异有统计学意义（匹配前 0 vs. 15.0%，P=0.028；匹配后 0 vs. 23.1%，P=0.023）。结论    对于具有高危复发危险的肝细胞癌病人，槐耳颗粒能够显著提高术后1年内无复发生存率并降低肝内多发转移的发生率，是一种有效的预防术后复发的治疗方案。

关键词: 肝细胞癌, 槐耳颗粒, 术后复发, 预防

Abstract: To investigate the clinical efficacy of Huaier granule in preventing postoperative recurrence in HCC patients associated with high-risk factors of recurrence. Methods    Between January 2019 and January 2022, 118 patients who were confirmed with high-risk factors of recurrence by pathological results (combined with microvascular invasion, tumor size ≥ 5 cm, or poor differentiation) in the First Affiliated Hospital of the University of Science and Technology of China（Anhui Provincial Hospital）were retrospectively analyzed. Based on whether they received Huaier granule or no further treatment after HCC resection, patients were divided into the Huaier group (38 cases) and the control group (80 cases). The primary endpoint was 1-year recurrence-free survival (RFS). Propensity score matching (PSM) was used to avoid possible selection bias. Results    The median follow-up time was 13 (2-40) months. Before PSM, there were significant differences in the proportion of males, positive for Hepatitis B surface antigen (HBsAg), alpha-fetoprotein (AFP)≥400 μg/L, and poor differentiation between the two groups (All P< 0.05). The 1-year RFS rates were 86.8% versus 51.2% (P<0.001) for the Huaier and control groups, respectively. The Cox proportional hazards model identified the Huaier granule as an independent predictor for recurrence-free survival (RFS) (HR=0.333,95%CI 0.162-0.686, P=0.003). In the propensity model, the baseline variables were well-balanced between the two groups（both P> 0.05). The 1-year RFS rates were 84.6% versus 57.7% (P=0.042) for the Huaier and control groups, respectively. The difference was still statistically  significant. Compared with the Huaier group, the control group had a higher incidence of intrahepatic multiple metastases (before PSM: 0 vs. 15.0%, P=0.028; after PSM: 0 vs. 23.1%, P=0.023). Conclusion    For HCC patients at a high risk of recurrence after radical resection, Huaier granules can significantly improve the 1-year RFS and reduce the incidence of intrahepatic multiple metastases. It is an effective adjuvant therapy to prevent recurrence after HCC resection.

Key words: hepatocellular carcinoma, Huaier granule, postoperative recurrence, prevention