CAJ | 학술논문

目的：探讨原发性肝癌（ PLC）手术治疗后生存率的影响因素。方法选取行肝癌手术切除治疗的PLC患者186例，随访患者生存率，统计影响患者预后的主要因素。结果186例患者均获随访，随访时间为7～84个月，中位随访时间41．5个月；随访生存时间8～92个月，中位生存期为51．2个月；患者1年、3年及5年总生存率分别为83．4％、68．4％及38．7％；患者1年、3年及5年无复发生存率分别为65．5％、32．6％及20．5％。肝硬化、肿瘤大小≥5 cm、术前甲胎蛋白水平＞400 ng／mL、甲胎蛋白术前术后变化、血管侵犯、辅助治疗方式及PLC家族史是影响患者预后的危险因素（P均＜0．05）。肝硬化、血管侵犯及甲胎蛋白术前术后变化是影响PLC患者治疗预后的独立危险因素（P均＜0．05）。结论 PLC术后生存率的影响因素较多，临床应综合考虑，对于高危患者应定期随访，及早诊断和治疗，以改善患者的预后。
목적：탐토원발성간암（ PLC）수술치료후생존솔적영향인소。방법선취행간암수술절제치료적PLC환자186례，수방환자생존솔，통계영향환자예후적주요인소。결과186례환자균획수방，수방시간위7～84개월，중위수방시간41．5개월；수방생존시간8～92개월，중위생존기위51．2개월；환자1년、3년급5년총생존솔분별위83．4％、68．4％급38．7％；환자1년、3년급5년무복발생존솔분별위65．5％、32．6％급20．5％。간경화、종류대소≥5 cm、술전갑태단백수평＞400 ng／mL、갑태단백술전술후변화、혈관침범、보조치료방식급PLC가족사시영향환자예후적위험인소（P균＜0．05）。간경화、혈관침범급갑태단백술전술후변화시영향PLC환자치료예후적독립위험인소（P균＜0．05）。결론 PLC술후생존솔적영향인소교다，림상응종합고필，대우고위환자응정기수방，급조진단화치료，이개선환자적예후。
Objective To explore the factors affecting survival rate of operation for primary liver carcinoma ( PLC ) . Methods 186 cases of patients with PLC treated by operation resection were chosen for the study,survival rate and the main fac-tors affecting the prognosis were analyzed during the follow-up.Results 186 patients received followed up,the follow-up time was 7~84 months,and the median follow-up time was 41.5 months.The follow-up survival time was 8~92 months,the median sur-vival time was 51.2 months.The 1-,3-and 5-year overall survival rates were 83.4%,68.4% and 38.7%,and the 1-,3-and 5-year relapse free survival rates were 65.5%,32.6%and 20.5%.Liver cirrhosis,tumor size(≥5 cm),preoperative alpha feto-protein level (>400 ng/mL) ,alpha fetoprotein ( AFP) preoperative and postoperative changes,vascular invasion,auxiliary treat-ment and family history of PLC were risk factors affecting prognosis (all P<0.05).Cirrhosis of the liver,vascular invasion and AFP preoperative and postoperative changes were the independent prognostic factors for patients with PLC (all P<0.05).Con-clusion There are many factors affecting the postoperative survival rate of PLC patients,all factors should be considered in clini-cal.For high-risk patients,the follow-up should be conducted regularly,and early diagnosis and treatment can improve the progno-sis of the patients.