巴塞罗那O期肝细胞癌患者术后肝内复发危险因素  

Risk factors of intrahepatic recurrence after resection for Barcelona Clinic Liver Cancer stage 0 hepatocellular carcinoma

作　　者：盛若凡 金开璞 陈旭晓 陈伶俐 饶圣祥 曾蒙苏 Sheng Ruofan;Jin Kaipu;Chen Xuxiao;Chen Lingli;Rao Shengxiang;Zeng Mengsu(Department of Radiology,Zhongshan Hospital,Fudan University;Shanghai Institute of Medical Imaging,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放射科上海市影像医学研究所,上海200032 [2]复旦大学附属中山医院肝外科 [3]复旦大学附属中山医院病理科

出　　处：《中华肝胆外科杂志》2018年第12期793-796,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金(81601488);上海市科学技术委员会“扬帆计划”(16YF1410600).

摘　　要：目的分析巴塞罗那临床肝癌(BCLC)分期0期肝细胞癌(HCC)术后肝内复发的危险因素。方法回顾分析复旦大学附属中山医院2011年1月至12月58例行手术切除的BCLC一0期的HCC患者资料。男性50例,女性8例,年龄31~72岁。收集患者术前临床、病理、MRI资料,并进行术后随访。比较肿瘤≤1.5cm(27例)和>1.5cm(31例)患者无复发生存率,采用Cox回归模型明确HCC肝内复发的危险因素。结果随访期间25例患者肝内复发,中位复发时间为33个月。3年及5年累积无复发生存率分别为73.0%(95%CI:60.7%~85.3%)及52.3%(95%CI:37.2%~67.4%)。肿瘤≤1.5cm与>1.5cm患者无复发生存期差异无统计学意义(P>0.05)。多因素分析结果显示甲胎蛋白(AFP)水平>20g/L(HR=3.773,95%CI:1.628~8.745,P<0.05)和肿瘤形态不规则(HR=4.584,95%“:1.485~14.155,P<0.05)为肝内复发的独立危险因素。结论AFP升高、肿瘤边缘形态不规则的BCLC一0期HCC患者术后肝内复发风险提高,可为临床预后分析提供参考。Objective To investigate the risk factors of intrahepatic recurrence after resection for Barcelona Clinic Liver Cancer (BCLC)stage 0hepatocellular carcinoma (HCC).Methods 58patients with pathologically confirmed BCLC stage 0HCC treated with liver resection at the Zhongshan Hospital, Fudan University from January to December 2011were included in this study.The male/female ratio was 50/8.The age ranged from 31to 72years.The clinical,pathological and MR imaging features of these patients were analyzed.The recurrence-free survival rates between patients with HCC ≤1.5cm (n=27)and >1.5cm (n =31)were compared.The risk factors of intrahepatic recurrence for HCCs were compared using the Cox regression analysis.Results Intrahepatic recurrence was identified in 25patients,and the median recurrence time was 33months.The 3-and 5-year cumulative recurrence-free survival rates were 73.0% (95%CI:60.7%-85.3%)and 52.3%(95%CI:37.2%-67.4%).No significant differences were found in the recurrence-free survival rates between tumors ≤1.5cm and >1.5cm (P>0.05).Multivariate analyses demonstrated that serum alpha-fetoprotein level >20g/L (HR 3.773,95%CI:1.628N 8.745;P<0.05)and irregular tumor shape (HR 4.584,95%CI:1.485~14.155;P<0.05)were independent risk factors of intra- hepatic recurrence.Conclusions Elevated serum alpha-fetoprotein level and irregular tumor shape were as sociated with an increased risk of intrahepatic recurrence for BCLC stage 0HCC patients after resection.They could be used as early prognostic indicators in clinical practice.

关 键 词：肝细胞癌 手术 复发 磁共振成像 巴塞罗那临床肝癌 

分 类 号：R735.7[医药卫生—肿瘤]