肝癌术后生存和临床病理因素的关系  

Relationship between liver cancer surgery survival and clinical pathological factors

作　　者：孙龙[1] 王能进[1] 

机构地区：[1]江苏省启东市人民医院病理科,江苏启东226200

出　　处：《中国现代医生》2013年第4期77-78,80,共3页China Modern Doctor

摘　　要：目的探寻影响肝癌术后生存的因素，为临床制定治疗措施提供参考依据。方法将78例肝癌手术患者分为术后生存5年以上组（A组）与3年内死亡组（B组）进行临床病理因素比较研究。结果提示两组术前AFP（＋）、HBsAg（＋）、有临床症状、肿瘤单结节、肿瘤距切缘〉1cm及癌组织学分级（Ⅰ、Ⅱ级）比较无统计学意义；而A组术后AFP转阴为82．05％（32／39）、临床TNM（Ⅰ-Ⅱ）分期87．18％（34／39）、普查发现69．23％（27／39）、癌周有包膜76．92％（30／39）、肿瘤长径≤5cm53．85％（21／39）、无癌栓率87．18％（34／39）、癌周有中重度硬化15．38％（6／39），显著或极显著地优于B组的AFP术后转阴率25．64％（10／39）、临床TNM（Ⅰ～Ⅱ）分期30．77％（12／39）、普查发现35．90％（14／39）、癌周有包膜20．51％（8／39）、肿瘤长径≤5cm20．51％（8／39）、无癌栓率30．77％（12／39）、癌周中重度硬化35．90％（14／39），（P〈0．05或P〈0．01）。结论除了部分临床及病理因素与术后生存时间长短无关外．极大多数临床病理因素与术后生存密切相关，与文献报道一致。Objective To explore the factors affecting the survival after liver cancer surgery in order to provide reference for the clinical development of therapeutic measures. Methods Seventy-eight patients receiving liver cancer surgery were divided into the more than 5 years＇ survival group （group A） and the death within 3 years group （group B）. The clinical pathological factors were compared. Results The two groups had no statistical significant differences in the preoperative AFP（＋）, HBs Ag（＋）, clinical symptoms, tumor single nodules, distance of tumor to cutting edge 〉 1 cm and histological grade of cancer （level Ⅰ and Ⅱ）. Group A showed a postoperative AFP negative rate of 82.05% （32/39）, clinical TNM （Ⅰ-Ⅱ） staging of 87.18% （34/39）, general survey detection of 69.23% （27/39）,peritumoral capsule of 76.92 % （30/39）, long tumor diameter ≤ 5 cm of 53.85%（21/39） ,non-cancer embolus rate of 87.18% （34/ 39） and peritumoral moderate and severe sclerosis of 15.38% （6/39）, which were significantly or highly significantly superior to the postoperative AFP negative rate of 25.64% （10/39）, clinical TNM （Ⅰ-Ⅱ） staging of 30.77% （12/39）, general survey detection of 35.90% （ 14/39）,peritumoral capsule of 20.51% （8/39）,long tumor diameter ≤ 5 cm of 20.51% （8/39） ,non-cancer embolus rate of 30.77% 12/39） and peritumoral moderate and severe sclerosis of 35.90% （14/39） （P 〈 0.05 or P 〈 0.01 ）. Conclusion Apart from some clinical pathological factors irrelevant to the length of postoperative survival time, most clinical pathological factors are closely related to the postoperative survival and consistent with the report.

关 键 词：肝细胞肝癌 病理因素 临床 长期生存 

分 类 号：R735.7[医药卫生—肿瘤]