目的 探究影响肝细胞癌（HCC）分化程度的临床病理特征和独立危险因素。方法 回顾整理经手术并治疗的HCC患者108例，根据病理诊断结果分为低分化组（n=29，26.85%）、中分化组（n=53，49.07%）、高分化组（n=26，24.07%）。比较分析各组患者临床病理特点及Ki67、P53表达水平，采用logistic回归模型分析影响肝细胞癌低分化的危险因素。结果 不同分化程度HCC肝硬化占比，P53阳性率和Ki67表达水平差异均有统计学意义（P＜0.05）；但是年龄、性别、肿瘤直径、是否感染肝炎病毒及肿瘤是否累及肝被膜的组间差异不具有统计学意义（P＞0.05）。多因素logistic分析显示：肝硬化（OR=3.408）、Ki67高表达（OR=11.113）及P53阳性（OR=9.711）为低分化HCC的主要危险因素。结论 不同分化程度HCC患者临床特征及Ki67和P53表达情况均存在不同程度差异，logistic回归分析找出影响HCC分化程度的临床病理危险因素，可为精准诊断和预后治疗提供判据支撑。
Abstract: Objective To investigate the clinicopathological characteristics and independent risk factors of hepatocellular carcinoma (HCC) differentiation. Methods A total of 108 HCC patients who underwent operation and treatment were reviewed and classified into low differentiation group (n= 29, 26.85%), medium differentiation group (n= 53, 49.07%) and high differentiation group (n= 26, 24.07%) according to pathological diagnosis. The clinicopathological characteristics and the expression levels of Ki67 and P53 in each group were compared and analyzed. Logistic regression model was used to analyze the risk factors for low differentiation of HCC. Results The proportion of cirrhosis, the positive rate of P53 and Ki67 expression level in different degrees of HCC differentiation were statistically significant (P < 0.05). However, there were no significant differences in age, sex, tumor diameter, and hepatitis virus infection or tumor involvement of liver capsule between groups (P > 0.05). Multivariate logistic analysis showed that cirrhosis (OR=3.408), high expression of Ki67 (OR=11.113) and positive P53 (OR=9.711) were the main risk factors for poorly differentiated HCC. Conclusion There are differences in clinical characteristics and expressions of Ki67 and P53 in HCC patients with different degrees of differentiation. Logistic regression analysis can identify clinicopathological risk factors affecting the degree of differentiation of HCC, which can provide criterion support for accurate diagnosis and prognostic treatment.