CAJ | 학술논문

目的探讨划分小肝癌大小定义的阈值选择.方法选择2003年12月至2013年7月在中国医学科学院北京协和医学院肿瘤医院接受手术的222例小肝癌患者临床,病理资料与随访,根据肝癌大小分为＜2 cm组、2～3 cm组与＞3～5 cm组.应用Kaplan-Meier法进行生存分析,组间应用log-rank法进行比较,采用COX风险比例模型进行多因素分析.结果本组患者1、3、5及10年生存率分别为:95.9％、85.3％、67.8％及53.3％.肿瘤≤3 cm组1、3及5年生存率分别为:98.3％、90.1％及72.1％,肿瘤＞3 ～5 cm组1、3及5年生存率分别为:93.1％、79.9％及62.8％,组间差异有统计学意义(x2=6.034,P=0.014).多因素分析结果显示:甲胎蛋白,肝癌分化程度,肝硬化,肿瘤被膜及肝癌直径(≤3 cm组与＞3 ～5 cm组)为肝癌患者的独立预后因素.结论本研究认为,在以2、3、5 cm为小肝癌的阈值划分中,以3 cm更具临床指导意义.该阈值与患者预后情况密切相关,同时可作为患者长期生存独立预测因素.
목적 탐토화분소간암대소정의적역치선택.방법 선택2003년12월지2013년7월재중국의학과학원북경협화의학원종류의원접수수술적222례소간암환자림상,병리자료여수방,근거간암대소분위＜2 cm조、2～3 cm조여＞3～5 cm조.응용Kaplan-Meier법진행생존분석,조간응용log-rank법진행비교,채용COX풍험비례모형진행다인소분석.결과 본조환자1、3、5급10년생존솔분별위:95.9％、85.3％、67.8％급53.3％.종류≤3 cm조1、3급5년생존솔분별위:98.3％、90.1％급72.1％,종류＞3 ～5 cm조1、3급5년생존솔분별위:93.1％、79.9％급62.8％,조간차이유통계학의의(x2=6.034,P=0.014).다인소분석결과현시:갑태단백,간암분화정도,간경화,종류피막급간암직경(≤3 cm조여＞3 ～5 cm조)위간암환자적독립예후인소.결론 본연구인위,재이2、3、5 cm위소간암적역치화분중,이3 cm경구림상지도의의.해역치여환자예후정황밀절상관,동시가작위환자장기생존독립예측인소.
Objective To explore the tumor size cut-off in the definition of small hepatocellular carcinoma(HCC).Methods We enrolled 222 small HCC cases undergoing hepatectomy in Cancer Hospital,Chinese Academy of Medical Sciences between December 2003 and July 2013.The clinical and pathological data were analyzed.Overall survival rates were evaluated by the Kaplan-Meier method and compared using the stratified log-rank test.For multivariate analysis,the stepwise COX's proportionalhazards models were used.Results The 1-,3-,5-and 10-year overall survival rates were 95.9％,85.3％,67.8％ and 53.3％ respectively in all patients.The 1-,3-and 5-year overall survival rates were 98.3％,90.1％,72.1％ in the group of tumor size ≤3 cm and 93.1％,79.9％,62.8％ in the group of tumor size ＞ 3-5 cm (x2 =6.034,P =0.014).The multifactor analysis showed that AFP,tumor differentiation,liver cirrhosis,capsular invasion and tumor size (≤ 3 cm vs ＞ 3-5 cm group) were independent prognostic factors.Conclusions It is advised to choose 3 cm as the tumor size cut-off in the definition of small HCC,which closly related to the prognosis of patients with HCC and can be considered as an independent prognostic factor for long survival.