CAJ | 학술논문

目的：探讨原发性肝癌患者手术治疗远期疗效的影响因素。方法413例原发性肝癌并行肝部分切除术患者，剔除失访的41例后，对其余372例患者的远期生存状况进行观察，并对其相关影响因素进行分析。结果5年生存率为14．78％（55/372），余317例死亡患者，根据术后是否存在复发转移分为复发转移组（n＝194）与非复发转移组（n＝123）。两组患者在有无乙肝及肝硬化、肿瘤大小、包膜完整与否、分化程度、是否存在血管癌栓及多结节融合等方面相对比，差异均有统计学意义（P＜0．05）；两组患者在术中出血量、输血情况、手术时间及肝门阻断时间、手术切缘、是否存在血管侵犯及肿瘤破裂等方面比较，差异并无统计学意义（P＞0．05）。经Logistic回归分析发现，乙肝、肝硬化、肿瘤大小、包膜完整与否、分化程度、多结节融合及血管癌栓是否存在，为影响原发性肝癌患者术后复发转移的独立危险因素（P＜0．05）。结论复发转移是影响患者远期生存状况的重要因素，而乙肝、肝硬化、肿瘤大小、包膜完整与否、分化程度、多结节融合及血管癌栓是否存在，为影响原发性肝癌患者术后复发转移的独立危险因素。
목적：탐토원발성간암환자수술치료원기료효적영향인소。방법413례원발성간암병행간부분절제술환자，척제실방적41례후，대기여372례환자적원기생존상황진행관찰，병대기상관영향인소진행분석。결과5년생존솔위14．78％（55/372），여317례사망환자，근거술후시부존재복발전이분위복발전이조（n＝194）여비복발전이조（n＝123）。량조환자재유무을간급간경화、종류대소、포막완정여부、분화정도、시부존재혈관암전급다결절융합등방면상대비，차이균유통계학의의（P＜0．05）；량조환자재술중출혈량、수혈정황、수술시간급간문조단시간、수술절연、시부존재혈관침범급종류파렬등방면비교，차이병무통계학의의（P＞0．05）。경Logistic회귀분석발현，을간、간경화、종류대소、포막완정여부、분화정도、다결절융합급혈관암전시부존재，위영향원발성간암환자술후복발전이적독립위험인소（P＜0．05）。결론복발전이시영향환자원기생존상황적중요인소，이을간、간경화、종류대소、포막완정여부、분화정도、다결절융합급혈관암전시부존재，위영향원발성간암환자술후복발전이적독립위험인소。
Objective To investigate the influencing factors of long-term effect of surgical treatment for primary liver cancer.Methods 413 cases of primary liver cancer patients were treated with partial liver resection .Of the 413 patients,41 de-faulting patients were excluded ,and long-term survival of the remaining 372 patients was observed ,and its related factors were an-alyzed.Results 5-year survival rate was 14.78%(55/372).The remaining 317 cases of patients who died after surgery ,accord-ing to the presence of metastatic recurrence were divided into recurrence group (n=194) and non-recurrence group (n=123). Two groups in hepatitis,cirrhosis,tumor size,encapsulated or not,differentiation,integration of multiple nodules and vascular thrombosis exists were compared,the differences were statistically significant (P<0.05);Two groups in blood loss,transfusion cases,surgery time and hilar occlusion time,surgical margin,whether vascular invasion and tumor rupture were compared ,the differences were not statistically significant (P>0.05).Logistic regression analysis showed that hepatitis ,cirrhosis,tumor size, encapsulated or not ,differentiation ,integration of multiple nodules and vascular thrombosis were independent risk factors of recur -rence and metastasis in patients with primary liver cancer (P<0.05).Conclusion Recurrence and metastasis is an important factor affecting long-term survival of patients.Hepatitis,cirrhosis,tumor size,encapsulated or not,differentiation,integration of multiple nodules and vascular thrombosis are independent risk factors of recurrence and metastasis in patients with primary liver cancer.