透明细胞型肝癌的临床病理特点及预后  

Primary clear cell carcinoma of the liver

作　　者：李涛[1] 樊嘉[1] 钦伦秀[1] 周俭[1] 孙惠川[1] 王鲁[1] 叶青海[1] 邱双键[1] 汤钊猷[1] 

机构地区：[1]复旦大学附属中山医院肝脏外科教育部癌变与侵袭原理重点实验室,上海200032

出　　处：《中华普通外科杂志》2012年第2期96-99,共4页Chinese Journal of General Surgery

基　　金：基金项目：国家自然科学基金资助项目（30901444）;山东大学自主创新基金资助项目（2010TS030）

摘　　要：目的探讨透明细胞型肝癌（primaryclearcellcarcinomaoftheliver，PCCCL）的临床病理特点及预后影响因素。方法回顾性分析1996年1月至2006年3月手术治疗的214例PCCCL患者的临床病理特点及预后因素。结果PCCCL患者的1，3，5年的总生存率分别为90．2％、70．6％和55．9％，显著优于非透明细胞型肝癌（non—clearcellhepatocellularcarcinoma，NHCC）患者（82．8％、62．7％和47．7％，P=0．001）。本组患者PCCCL肿瘤显著小于NHCC（x^2=4．37，P=0．04），血管侵犯显著少于NHCC（x^2=9．42，P=0．002），而高分化肿瘤所占的比例则显著高于NHCC（x^2=4．30，P=0．04）。甲胎蛋白水平，肿瘤大小，肝硬化及血管侵犯是影响PCCCL患者总生存率和无瘤生存率的独立预后因素。结论PCCCL为肝细胞肝癌的一种少见的病理类型，具有与NHCC不同的临床病理特点。手术切除是PCCCL最佳治疗手段，预后显著好于NHCC。Objective To investigatethe clinicopathologic characteristics and prognostic factors of primary clear cell carcinoma of the liver（PCCCL）. Methods A total of 214 PCCCL patients treated by curative resection from January 1996 to March 2006 were retrospectively analyzed. Results The 1-, 3-, and 5-year overall survival （OS） rates for PCCCL patients were significantly better than those of non-clear cell hepatocellular carcinoma （ NHCC ） patients （ 90. 2%, 70.6%, and 55.9% vs 82. 8%, 62. 7% and 47.7% , P = 0. 001 ）. Tumor size was significantly smaller in PCCCL group than in NHCC group （x^2 = 4. 37 ,P = 0. 04）. Tumors of PCCCL group had a lower incidence of vascular invasion （ x^2 = 9.42, P = 0. 002） and a better differentiation than those of NHCC group （x^2 = 4. 30, P = 0. 04）. Serum a-fetoprotein （AFP） level, tumor size, liver cirrhosis, and vascular invasion were independent risk factors impacting OS and disease-free survival （DFS） of PCCCL. Conclusions PCCCL is an uncommon subtype of HCC and has different clinicopathologic characteristics from NHCC. Complete surgical resection is the optimal treatment for PCCCL and its prognosis is much better than that of NHCC.

关 键 词：癌 肝细胞 危险因素 预后 

分 类 号：R735.7[医药卫生—肿瘤]