维生素K2预防肝癌根治术后肿瘤复发  

Preventive effects of vitamin K2 on tumor recurrence in patients with hepatocellular carcinoma after radical resection

作　　者：杨明[1] 勉闻光[2] 肖亮[3] 施晓敏[3] 傅志仁[3] 

机构地区：[1]解放军第一八一医院医务处,桂林541002 [2]广州军区联勤部卫生部医疗处,510063 [3]上海长征医院器官移植科,200003

出　　处：《中华消化外科杂志》2009年第4期284-286,共3页Chinese Journal of Digestive Surgery

基　　金：军队“十五”重点课题（01Z061）

摘　　要：目的探讨维生素K2在预防肝癌根治术后肿瘤复发中的作用。方法收集2006年3月至2007年3月在解放军第一八一医院接受肝癌根治术50例患者的临床资料，按随机数字表法分为两组：维生素K2组26例，每天口服维生素K245mg；对照24例，未服用维生素K2。采用Kaplan—Meier法计算累积生存率和无瘤生存率，Log-rank法检验组间差异，Cox回归模型进行预后多因素分析。结果最长随访时间36个月，死亡10例，复发28例。维生素K2组患者1、2、3年累积生存率分别为96％、92％、83％，对照组患者分别为96％、82％、63％，两组比较差异无统计学意义（χ^2=3．61，P〉0．05）；维生素K2组患者1、2、3年无瘤生存率分别为92％、60％、38％，对照组患者分别为75％、42％、12％，两组比较差异有统计学意义（χ^2=5．61，P〈0．05）。未服用维生素K2、术前AFP≥800μg/L、血管侵犯是术后肿瘤复发的独立危险因素。结论维生素K2可有效降低肝癌根治术后肿瘤复发率，但术前AFP≥800μg／L或有血管侵犯者预后不佳。Objective To study the preventive effects of vitamin K2 on tumor recurrence in patients with hepatocellular carcinoma （HCC） after radical resection. Methods The clinical data of 50 patients with HCC who received radical resection from March 2006 to March 2007 in No. 181 Hospital of PLA were analyzed retrospectively. All the patients were divided into 2 groups according to the random number table. Twenty-six patients in vitamin K2 group were administered with menatetrenone （45 mg per day） , and the rest 24 pateints were in the control group. The accumulative and tumor-free survival rates, differences between the 2 groups, multivariate factors for prognosis were analyzed by Kaplan-Meier curve, Log-rank test and Cox regression model, respectively. Results During a period of 36 month follow-up, 10 patients died and 28 had tunor recurrence. The 1-, 2-, 3-year accumulative survival rates were 96%, 92% and 83% in vitamin Kz group, and 96% , 82% and 63% in control group （χ^2 = 3.61 , P 〉 0.05）. The 1-, 2-, 3-year tumor-free survival rates were 92% , 60% and 38% in vitamin K2 group, and 75%, 42% and 12% in control group, with significant difference between the 2 groups （χ^2 = 5.61, P 〈 0.05 ）. Univariate and multivariate Cox proportional hazard analysis showed that without taking menatetrenone, the preoperative level of alpha fetoprotein （AFP） ≥800 μg/L and vascular invasion were the independent risk factors for tumor recurrence. Conclusions Vitamin K2 has a suppressive effect on tumor recurrence of HCC, while patients with AFP≥800 μg/L before operation or with vascular invasion have poor prognosis.

关 键 词：肝肿瘤 维生素K2 复发 

分 类 号：R735.7[医药卫生—肿瘤]