Abstract: Objective To investigate the correlated factors of pulmonary metastasis of hepatocellular  carcinoma(HCC), so as to provide theoretical evidences for the prevention and treatment.
Methods The clinical data of 862 patients with HCC who were admitted to the First Affiliated Hospital of Fujian Medical University from January 2008 to March 2012 were retrospectively analyzed. There were 107 patients with pulmonary metastasis. Factors including serum alpha fetoprotein (AFP) level, serum gamma glutamyl transpeptidase (GGT) level, hepatitis B virus (HBV) infection, presence and treatment of intrahepatic tumor were analyzed to screen out relevant factors of pulmonary infection of HCC. Univariate and multivariate COX regression model analysis were performed for data analysis.
Results The results of univariate analysis showed that high level of AFP (≥400 μg/L), ultrahigh level of GGT (≥150 U/L), presence of HBV infection, the number of intrahepatic tumors≥2, no radical resection (or radiofrequency ablation) for intrahepatic tumors, combining with tumor thrombi in the vessels, lymph node metastasis were risk factors of pulmonary metastasis of HCC (RR=1.986, 3.653, 0.365, 3.675, 0.252, 0.379, 0.352, P<0.05). The results of multivariate analysis showed that high level of AFP (≥400 μg/L), HBV infection, the number of intrahepatic tumors≥2, no radical resection (or radiofrequency ablation) for intrahepatic tumors, combining with tumor thrombi in the vessels were risk factors of pulmonary metastasis of HCC (RR=2.391, 3.462, 3.425, 3.396, 2.418, 0.638, P<0.05).
Conclusions AFP≥ 400 μg/L,HBV infection, the number of intrahepatic tumors≥2, no radical resection (or radiofrequency ablation), tumor thrombi in the vessels and lymph node metastasis are risk factors of pulmonary metastasis of HCC. Anti hepatitis virus treatment and early treatment are helpful for the prevention and treatment.