肝细胞癌治疗后肝内复发的临床病理特征  

Clinical and pathological factors of intrahepatic recurrenceafter initial treatment in patients with hepatocelluar carcinoma

作　　者：文明[1] 蒋明东[2] 彭志平[3] 李少林[3] 袁书伟[1] 阎雄[4] 彭云[5] 唐红兵 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]重庆市第九人民医院放射肿瘤科,重庆406231 [3]重庆医科大学基础医学院,重庆400016 [4]重庆医科大学附属第一医院肝胆外科,重庆400016 [5]华蓥市广能医院,四川638500 [6]重庆钢铁公司职工总医院介入放射科,重庆400084

出　　处：《重庆医科大学学报》2006年第2期268-271,共4页Journal of Chongqing Medical University

摘　　要：目的:评价肝细胞癌(HCC)治疗后肝内复发的临床病理特征。方法:收集57例病理证实的HCC复发病例,依据复发类型分为多中心发生(MO)和肝内转移(IM)两组,采用单变量和多变量统计学模式,分析临床资料及病理学类型间的关系。结果:HCC治疗后累计复发率分别为1年24.56%、2年47.37%、3年63.16%、4年70.18%、5年75.44%。MO与肝炎病史和AFP浓度密切相关,预后相对较好,而IM组复发与肿瘤细胞分化程度相关,且多在3年内出现。结论:MO和IM肿瘤的发展及生物学行为完全不同,早期发现肝内复发病灶并采取恰当的治疗,可以延长MO患者的生存率。Objective： To investigate the clinical and pathological factors of intrahepatic recurrence after initial treatment in patients with hepatocelluar carcinoma （HCC）. Methods： 57 consecutive patients with pathologically proven recurrent HCC were collected. And these cases were classified into two groups： multicentric occurrence （MO） group and intrahepatic metastasis （IM） based on the type of recurrence. The univariate and multivariate analysis were used for the relationship between the clinical datum and pathological types. Results： Overall recurrence rates after initial treatment were 24.56% at 1 year, 47.37% at 2 years, 63.16% at 3 years, 70.18% at 4 years, and 75.44% at 5 years, respectively. MO was closely associated with hepatitis and AFP concentration, and showed better prognoses. While in patients with IM, the lesions related to the degree of tumor cell differentiation and the majority of recurrences were observed within 3 years. Conclusion： The development and biological behaviors of the MO and IM were quite different. Early detection of intrahepatic recurrence and institute appropriate therapy may prolong survival in patients with MO.

关 键 词：肝细胞癌 复发 病理 

分 类 号：R735.7[医药卫生—肿瘤]