中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
6期
466-468
,共3页
杨立涛%王新保%张云利%周一鸣%王兵%程向东%郭剑民
楊立濤%王新保%張雲利%週一鳴%王兵%程嚮東%郭劍民
양립도%왕신보%장운리%주일명%왕병%정향동%곽검민
癌,肝细胞%肝切除术%肿瘤复发,局部%预测因素
癌,肝細胞%肝切除術%腫瘤複髮,跼部%預測因素
암,간세포%간절제술%종류복발,국부%예측인소
Carcinoma,hepatocellular%Hepatectomy%Neoplasm recurrence,local%Forecasting factors
目的 探讨肝细胞癌(hepatoeellular carcinoma,HCC)切除术后早期肝内复发的预测因素及复发对预后的影响.方法 收集184例HCC患者切除术后肝内复发病例的临床病理资料,回顾性分析可能与早期肝内复发有关的13项临床病理学因素以及复发时间对HCC患者复发后生存期的影响.结果 单因素分析表明术前血清AFP>100 ng/ml(P=0.009)、肿瘤直径>5 cm(P<0.001)、血管浸润(P=0.001)以及术中输血(P=0.025)与HCC切除术后早期肝内复发有关;白蛋白<35S/L(P=0.083)可能与术后早期肝内复发有关.多因素分析表明 AFP>100 ng/ml(P=0.015)、肿瘤>5 cm(P=0.001)、微血管浸润(P=0.004)是与HCC切除术后早期肝内复发的独立的预测因素.早期肝内复发组复发后中位生存期(12个月)明显低于晚期复发组(18个月)(P=0.012).结论 术前AFP、肿瘤大小和血管浸润是HCC术后早期肝内复发的预测因素.HCC术后早期肝内复发病例预后不良.
目的 探討肝細胞癌(hepatoeellular carcinoma,HCC)切除術後早期肝內複髮的預測因素及複髮對預後的影響.方法 收集184例HCC患者切除術後肝內複髮病例的臨床病理資料,迴顧性分析可能與早期肝內複髮有關的13項臨床病理學因素以及複髮時間對HCC患者複髮後生存期的影響.結果 單因素分析錶明術前血清AFP>100 ng/ml(P=0.009)、腫瘤直徑>5 cm(P<0.001)、血管浸潤(P=0.001)以及術中輸血(P=0.025)與HCC切除術後早期肝內複髮有關;白蛋白<35S/L(P=0.083)可能與術後早期肝內複髮有關.多因素分析錶明 AFP>100 ng/ml(P=0.015)、腫瘤>5 cm(P=0.001)、微血管浸潤(P=0.004)是與HCC切除術後早期肝內複髮的獨立的預測因素.早期肝內複髮組複髮後中位生存期(12箇月)明顯低于晚期複髮組(18箇月)(P=0.012).結論 術前AFP、腫瘤大小和血管浸潤是HCC術後早期肝內複髮的預測因素.HCC術後早期肝內複髮病例預後不良.
목적 탐토간세포암(hepatoeellular carcinoma,HCC)절제술후조기간내복발적예측인소급복발대예후적영향.방법 수집184례HCC환자절제술후간내복발병례적림상병리자료,회고성분석가능여조기간내복발유관적13항림상병이학인소이급복발시간대HCC환자복발후생존기적영향.결과 단인소분석표명술전혈청AFP>100 ng/ml(P=0.009)、종류직경>5 cm(P<0.001)、혈관침윤(P=0.001)이급술중수혈(P=0.025)여HCC절제술후조기간내복발유관;백단백<35S/L(P=0.083)가능여술후조기간내복발유관.다인소분석표명 AFP>100 ng/ml(P=0.015)、종류>5 cm(P=0.001)、미혈관침윤(P=0.004)시여HCC절제술후조기간내복발적독립적예측인소.조기간내복발조복발후중위생존기(12개월)명현저우만기복발조(18개월)(P=0.012).결론 술전AFP、종류대소화혈관침윤시HCC술후조기간내복발적예측인소.HCC술후조기간내복발병례예후불량.
Objective To investigate the predictive factors and prognosis of early intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC).Methods Clinicopathological dats of 184 HCC patients with intrahepatic recurrence after curative resection were collected.Thirteen clinicopathological factors and prognosis after recurrence were retrospectively analyzed. Results Univariate analysis showed that preoperative scrota alpha-fetoprotein(AFP)>100 ng/ml,tumour size>5 cm,venous invasion and intra-operative blood transfusion were predictive factors of early intrahepatic recurrence,and selum albumin<35 g/L was marginally predictive factor.Multivariate analysis showed that serum AFP>100 ng/ml,tumour size>5 cm and venous invasion were independent predictive factots of early intrahepatic recurrence.The survival of patients suffering from early recurrence was significantly shorter than those with late recurrence.with median survival period of 12 mos vs 18 mos(P=0.012).Conclusion Serum AFP,tumour size and venous invasion were independent predictive factors of early intrahepatic recurrence in HCC patients after radical resection of the primary tumor.Early intrahepatic recurrence implies poor prognosis.
