中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2009年
10期
748-750
,共3页
武聚山%卢实春%王孟龙%李宁%夏仁品%郭庆良%赖威%张毅%杨光%刘源
武聚山%盧實春%王孟龍%李寧%夏仁品%郭慶良%賴威%張毅%楊光%劉源
무취산%로실춘%왕맹룡%리저%하인품%곽경량%뢰위%장의%양광%류원
肝移植%肝癌%生存率
肝移植%肝癌%生存率
간이식%간암%생존솔
Liver transplantation%Hepatocellular carcinoma%Survival rate
目的 比较不同受体选择标准肝癌肝移植的远期疗效,分析肝痛肝移植术后肿瘤复发相关因素.方法 总结北京佑安医院2004年4月至2008年3月间的103例肝癌肝移植的临床资料,按照肿瘤的特征将其分为3组:符合米兰标准组(A组)、超出米兰标准但满足UCSF标准组(B组)和超出UCSF标准组(C组),比较3组的总体生存率及无瘤生存率,并分析影响远期预后的相关因素.结果 103例肝癌肝移植总体1、2、3年存活率分别为84.0%、70.5%和60.2%.其中A组50例,1、2、3年生存率和无瘤生存率分别为93.4%、83.8%、73.2%和97.3%、93.9%、88.7%;B组17例,1、2、3年生存率和无瘤生存率分别为93.3%、79.4%、66.2%和86.7%、79.4%、66.2%;C组36例,1、2、3年生存率和无瘤牛存率分别为67.0%、45.5%、34.1%和65.8%、50.0%、41.7%.远期生存率A组与B组比较无差异(P=0.631),A组、B组与C组比较具有统计学差异(P值分别为0.001,0.045).结论 米兰标准是肝癌肝移植最佳适应证,超出米兰标准但满足UCSF标准也可获得满意的远期疗效;肿瘤的分期和微血管侵犯是影响远期预后的风险因素.
目的 比較不同受體選擇標準肝癌肝移植的遠期療效,分析肝痛肝移植術後腫瘤複髮相關因素.方法 總結北京祐安醫院2004年4月至2008年3月間的103例肝癌肝移植的臨床資料,按照腫瘤的特徵將其分為3組:符閤米蘭標準組(A組)、超齣米蘭標準但滿足UCSF標準組(B組)和超齣UCSF標準組(C組),比較3組的總體生存率及無瘤生存率,併分析影響遠期預後的相關因素.結果 103例肝癌肝移植總體1、2、3年存活率分彆為84.0%、70.5%和60.2%.其中A組50例,1、2、3年生存率和無瘤生存率分彆為93.4%、83.8%、73.2%和97.3%、93.9%、88.7%;B組17例,1、2、3年生存率和無瘤生存率分彆為93.3%、79.4%、66.2%和86.7%、79.4%、66.2%;C組36例,1、2、3年生存率和無瘤牛存率分彆為67.0%、45.5%、34.1%和65.8%、50.0%、41.7%.遠期生存率A組與B組比較無差異(P=0.631),A組、B組與C組比較具有統計學差異(P值分彆為0.001,0.045).結論 米蘭標準是肝癌肝移植最佳適應證,超齣米蘭標準但滿足UCSF標準也可穫得滿意的遠期療效;腫瘤的分期和微血管侵犯是影響遠期預後的風險因素.
목적 비교불동수체선택표준간암간이식적원기료효,분석간통간이식술후종류복발상관인소.방법 총결북경우안의원2004년4월지2008년3월간적103례간암간이식적림상자료,안조종류적특정장기분위3조:부합미란표준조(A조)、초출미란표준단만족UCSF표준조(B조)화초출UCSF표준조(C조),비교3조적총체생존솔급무류생존솔,병분석영향원기예후적상관인소.결과 103례간암간이식총체1、2、3년존활솔분별위84.0%、70.5%화60.2%.기중A조50례,1、2、3년생존솔화무류생존솔분별위93.4%、83.8%、73.2%화97.3%、93.9%、88.7%;B조17례,1、2、3년생존솔화무류생존솔분별위93.3%、79.4%、66.2%화86.7%、79.4%、66.2%;C조36례,1、2、3년생존솔화무류우존솔분별위67.0%、45.5%、34.1%화65.8%、50.0%、41.7%.원기생존솔A조여B조비교무차이(P=0.631),A조、B조여C조비교구유통계학차이(P치분별위0.001,0.045).결론 미란표준시간암간이식최가괄응증,초출미란표준단만족UCSF표준야가획득만의적원기료효;종류적분기화미혈관침범시영향원기예후적풍험인소.
Objective To compare the long-term survivals of orthotropic liver transplantation (OLT) in HCC patient within different selection criteria and analyze the risk factors of tumor recurrence after liver transplantation.Methods OLT was performed in 103 patients with HCC in our hospital between April 2004 and March 2008.The data were retrospectively analyzed with regard to the response to OLT and survival.The patients were divided into three groups according to the characteristics of tumor:group A (within Milan criteria),group B (extra Milan criteria within UCSF criteria) and group C (beyond UCSF criteria).Accumulative survival rate and tumor-free survivals were compared among the 3 groups.Result The 1-,2-,3-year accumulative survival rates of 103 patients were 84.0%,70.5% and 60.2%,which were 93.4%,83.8%,73.2% in group A (n=50),93.3%,79.4%,66.2% in group B (n=17) and 67.0%,45.5%,34.1% in group C (n=36),respectively.There was no significant difference in long-term survival rate between group A and group B (P=0.631),while significant difference between group A and group C (P=0.001) or group B and group C (P=0.045) was found.Conclusion HCC fulfilling Milan criteria is best indicated for liver transplantation,and satisfied outcomes can be achieved for the HCC recipients exceeding Milan criteria but within UCSF criteria as well.Prognostic risk factors are tumor staging and microvascular invasion of the tumor.
