中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2012年
8期
578-581
,共4页
李涛%樊嘉%钦伦秀%周俭%孙惠川%叶青海%邱双键%王鲁%汤钊猷
李濤%樊嘉%欽倫秀%週儉%孫惠川%葉青海%邱雙鍵%王魯%湯釗猷
리도%번가%흠륜수%주검%손혜천%협청해%구쌍건%왕로%탕쇠유
肝脏%透明细胞%癌%危险因素%复发
肝髒%透明細胞%癌%危險因素%複髮
간장%투명세포%암%위험인소%복발
Liver%Clear cell%Carcinoma%Risk factors%Recurrence
目的 探讨影响透明细胞型肝癌(primary clear cell carcinoma othe liver,PCCCL)术后早期及晚期复发的相关危险因素.方法 对1996年1月至2006年3月手术治疗的214例PCCCL 患者临床病理及随访资料进行回顾性分析.术后≤1年复发者定义为早期复发,术后1年以上复发者定义为晚期复发.结果 99例患者术后复发,其中早期复发者28例,晚期复发者71例.复发患者的3年及5年总生存率分别为88.7％和46.2％,显著低于未复发患者(72.2％和64.3％,P=0.003).晚期复发患者1年、3年和5年的总生存率分别为100％、80.3％和54.6％,显著优于早期复发患者(85.7％、39.3％和25.0％,P=0.001).多因素分析显示丙氨酸转氨酶(aminoleucine transferase,ALT)水平和血管侵犯是PCCCL术后早期复发的独立危险因素,而年龄则是PCCCL患者术后晚期复发的惟一独立危险因素.结论 复发时间是影响PCCCL术后复发患者预后的主要因素.明确PCCCL早期及晚期复发的不同危险因素,有助于指导患者术后随访并及时发现复发,提高生存率.
目的 探討影響透明細胞型肝癌(primary clear cell carcinoma othe liver,PCCCL)術後早期及晚期複髮的相關危險因素.方法 對1996年1月至2006年3月手術治療的214例PCCCL 患者臨床病理及隨訪資料進行迴顧性分析.術後≤1年複髮者定義為早期複髮,術後1年以上複髮者定義為晚期複髮.結果 99例患者術後複髮,其中早期複髮者28例,晚期複髮者71例.複髮患者的3年及5年總生存率分彆為88.7％和46.2％,顯著低于未複髮患者(72.2％和64.3％,P=0.003).晚期複髮患者1年、3年和5年的總生存率分彆為100％、80.3％和54.6％,顯著優于早期複髮患者(85.7％、39.3％和25.0％,P=0.001).多因素分析顯示丙氨痠轉氨酶(aminoleucine transferase,ALT)水平和血管侵犯是PCCCL術後早期複髮的獨立危險因素,而年齡則是PCCCL患者術後晚期複髮的惟一獨立危險因素.結論 複髮時間是影響PCCCL術後複髮患者預後的主要因素.明確PCCCL早期及晚期複髮的不同危險因素,有助于指導患者術後隨訪併及時髮現複髮,提高生存率.
목적 탐토영향투명세포형간암(primary clear cell carcinoma othe liver,PCCCL)술후조기급만기복발적상관위험인소.방법 대1996년1월지2006년3월수술치료적214례PCCCL 환자림상병리급수방자료진행회고성분석.술후≤1년복발자정의위조기복발,술후1년이상복발자정의위만기복발.결과 99례환자술후복발,기중조기복발자28례,만기복발자71례.복발환자적3년급5년총생존솔분별위88.7％화46.2％,현저저우미복발환자(72.2％화64.3％,P=0.003).만기복발환자1년、3년화5년적총생존솔분별위100％、80.3％화54.6％,현저우우조기복발환자(85.7％、39.3％화25.0％,P=0.001).다인소분석현시병안산전안매(aminoleucine transferase,ALT)수평화혈관침범시PCCCL술후조기복발적독립위험인소,이년령칙시PCCCL환자술후만기복발적유일독립위험인소.결론 복발시간시영향PCCCL술후복발환자예후적주요인소.명학PCCCL조기급만기복발적불동위험인소,유조우지도환자술후수방병급시발현복발,제고생존솔.
Objective To investigate the risk factors influencing early and late recurrences after resection of primary clear cell carcinoma of the liver (PCCCL).Methods 214 PCCCL patients treated by curative resection from January 1996 to March 2006 were retrospectively analyzed.Recurrences were classified into early (≤1 year) and late (＞1 year) recurrences.Results 99 patients developed recurrences,with early recurrence in 28 patients and late recurrence in 71 patients.The 3-and 5-year overall survival (OS) rates for recurrent PCCCL were significantly worse than those with no recurrence (68.7％ and 46.2％ vs 72.2％ and 64.3％,P=0.003).The 1-,3-and 5-year OS rates for late recurrence were 100％,80.3％ and 54.6％,which were significantly better than those with early recurrence (85.7％,39.3％ and 25.0％,P=0.001).On multivariate analysis,aminoleucine transferase (ALT) level and vascular invasion were independent risk factors for early recurrence,while age was the only significant risk factor for late recurrence.Conclusions The time to recurrence was the main determinant for prognosis of recurrent PCCCL,Clarifying the different risk factors for early and late recurrences will help postoperative follow-up,early detection of recurrence,and hopefully will improve survival.
