CAJ | 학술논문

目的：探讨手术治疗乙肝相关肝癌的预后及患者生存风险因素。方法选择行手术切除的乙肝相关肝癌患者80例。统计患者的年龄，术前AFP，HbsAg，肿瘤直径，肝功能，有无肝硬化和卫星灶。术后第1年每月通过电话或门诊随访1次，随后每3个月随访1次，共随访3年。结果手术切除乙肝相关肝癌患者的中位生存时间为30个月，术后1年、2年、3年的累积生存率分别为78．8％、55．0％和35．0％，术后1、2、3年复发率分别是8．2％，25．1％和50．4％。单因素分析显示肿瘤直径、肝功能、肝硬化和卫星灶是影响患者生存时间的相关因素；HbsAg、肿瘤直径、肝功能、肝硬化和卫星灶是影响术后复发率的相关因素。 COX模型分析显示肝硬化和卫星灶是影响患者长期生存的独立危险因素。结论肿瘤进展情况及肝脏储备能力是影响乙肝相关肝癌患者预后的主要因素。
목적：탐토수술치료을간상관간암적예후급환자생존풍험인소。방법선택행수술절제적을간상관간암환자80례。통계환자적년령，술전AFP，HbsAg，종류직경，간공능，유무간경화화위성조。술후제1년매월통과전화혹문진수방1차，수후매3개월수방1차，공수방3년。결과수술절제을간상관간암환자적중위생존시간위30개월，술후1년、2년、3년적루적생존솔분별위78．8％、55．0％화35．0％，술후1、2、3년복발솔분별시8．2％，25．1％화50．4％。단인소분석현시종류직경、간공능、간경화화위성조시영향환자생존시간적상관인소；HbsAg、종류직경、간공능、간경화화위성조시영향술후복발솔적상관인소。 COX모형분석현시간경화화위성조시영향환자장기생존적독립위험인소。결론종류진전정황급간장저비능력시영향을간상관간암환자예후적주요인소。
Objective To investigate the risk factors of prognosis and survival of surgical treatment for patients with HBV-related liver.Methods 80 cases of HBV-related liver cancer patients with surgical resection were selected.Age,preopera-tive AFP,HBsAg,tumor size,liver function,cirrhotic and satellite lesions of patients were collected.After the operation,once a monthly follow-up were made by telephone or outpatient in the first year,then every 3 months follow-up were made for 3 years. Results The median survival time of operation resection for HBV-related liver cancer patients was 30 months,the cumulative 1-, 2-,3-year survival rates were 78.8%,55.0%,and 35.0% and the 1-,2-,3-year recurrence rates were 8.2%,25.1% and 50.4%,respectively.Univariate analysis showed that tumor size,liver function,liver cirrhosis and satellite lesions were the related factors for the survival of patients.HBsAg,tumor size,liver function,cirrhotic,and satellite lesions were influencing factors related to the recurrence rate after operation.COX model analysis showed that cirrhotic and satellite lesions were independent risk factors influencing long-term survival.Conclusion The progress of liver cancer and reserve capacity are the main factor affecting the prognosis of HBV-related liver cancer.