门静脉微癌栓和肉眼癌栓对肝癌患者术后生存的影响  

The effects of portal vein microscopic and macroscopic tumor thrombi on post-operation patients with hepatocellular carcinoma

作　　者：樊嘉[1] 汤钊猷[1] 吴志全[1] 周俭[1] 周信达[1] 马曾辰[1] 钦伦秀[1] 邱双健[1] 余耀[1] 黄成[1] 

机构地区：[1]复旦大学肝癌研究所复旦大学附属中山医院肝脏外科,上海200032

出　　处：《中华外科杂志》2005年第7期433-435,共3页Chinese Journal of Surgery

基　　金：上海百人计划基金资助项目(97BR029);上海科技发展基金资助项目(984419067)

摘　　要：目的　评价肝癌门静脉微癌栓和肉眼癌栓对术后生存的影响。方法　回顾性分析3348例肝癌切除术患者的临床资料,分为门静脉无癌栓组(n=2528)、微癌栓组(n=416)和肉眼癌栓组(n=404),单因素分析肝癌门静脉微癌栓和肉眼癌栓对术后生存的影响,分析各组的生存率。结果　单因素分析肝癌门静脉微癌栓和门静脉肉眼癌栓对术后生存影响的危险度分别为1 421和3 136;无癌栓组的1、3、5、10年累积生存率分别为85. 97%、62 .78%、49 .88%、35 .42%,中位生存时间为59 7个月;微癌栓组的1、3、5、10年累积生存率分别为74 .42%、51. 66%、39 .25%、27 .28%,中位生存时间为39 .1个月; 肉眼癌栓组的1、3、5、10年累积生存率分别为52 59%、25. 97%、20 .42%、11 .33%,中位生存时间为13. 5个月。结论　门静脉癌栓是影响肝癌患者术后生存的重要因素,而肉眼癌栓的危险性远大于微癌栓;微癌栓阶段是影响术后生存的转折点。Objective To evaluate the effects of portal vein microscopic and macroscopic tumor thrombi on post-operation patients with hepatocellular carcinoma (HCC).Methods Three thousand three hundred and forty eight HCC patients were retrospectively reviewed, which were divided into no portal vein tumor thrombi (PVTT), microscopic PVTT and macroscopic PVTT groups according to the pathology, effects of portal vein microscopic and macroscopic tumor thrombi on post-operation patients′s survival were studied by univariate analysis and overall survival was evaluated in each group.Results Hazard ratio(HR) of portal vein microscopic tumor thrombi and macroscopic tumor thrombi was 1.421 and 3.136 respectively; The overall 1-,3-,5- and 10-year cumulative survival rate was 85.97%,62.78%,49.88% and 35.42% respectively, and mean time for survival was 59.7 months in group without PVTT, while 74.42%,51.66%,39.25% and 27.28% respectively and mean time for survival 39.1 months in group with microscopic PVTT, 52.59%,25.97%,20.42% and 11.33% respectively and mean time for survival 13.5 months in group with macroscopic PVTT.Conclusions PVTT was an important prognostic factor for survival in post-operation patients with HCC while macroscopic PVTT was more danger than microscopic PVTT. The period of microscopic PVTT was the landmark affecting post-operation survival.

关 键 词：门静脉微癌栓 肉眼癌栓 肝癌 术后 生存质量 肿瘤细胞 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]