肝细胞癌患者术后总生存的相关因素分析  

Association between clinicopathological features and postoperative overall survival of patients with hepatocellular carcinoma

作　　者：胡柳燕[1] 贺松琴[1] 闻炳基[1] 陈律[2] 艾婷婷[1] 余慈波 张静[1] 王爱忠[1] 朱忠政[1] 

机构地区：[1]中国人民解放军第113医院,宁波315040 [2]宁波大学医学院

出　　处：《现代实用医学》2014年第9期1061-1063,1086,共4页Modern Practical Medicine

基　　金：国家自然科学基金(30470791);南京军区医学科技创新基金(08MA023);宁波市自然科学基金(2009A610126)

摘　　要：目的 探讨肝细胞癌（HCC）术后总生存（OS）相关的临床病理学参数.方法 纳入HCC患者66例,随访根治性术后OS情况,平均随访时间（39.2±25.6）个月（2.6～73.3个月）.临床病理学参数与OS的相关性分析采用Log-rank检验、Kaplan-Meier曲线和多变量Cox风险比例模型.结果 单因素分析结果显示,血清α-L岩藻糖苷酶（AFU）水平、有无完整肿瘤包膜和TNM分期与OS呈显著性相关（均P＜0.05）;多变量Cox回归分析显示,肝功能Child分级B级、无完整肿瘤包膜和TNM Ⅲ期是HCC术后不良OS的独立预后因素.结论 肿瘤包膜完整性以及TNM分期和肝功能Child分级是HCC术后OS的独立预后因素,肿瘤包膜完整性评估和预后指导意义应得到病理与临床医生的充分重视.Objective To investigate the clinicopathological features associated with postoperative overall survival（OS） of patients with hepatocellular carcinoma（HCC）. Methods A total of 66 patients with HCC were enrolled.Follow-up data were available for all patients, and mean follow-up time was 39.2±25.6 months（from 2.6 to 73.3 months）. The association between clinicopathological features and OS was analyzed by Log-rank test, Kaplan-Meier survival analysis and Cox proportional hazards models. Results Univariate analysis of the association between clinicopathological features and OS showed that elevated serum alpha-L-fucosidase（AFU）, absence of tumor capsule integrity, and advanced TNM stage（stage III） were significantly associated with poor OS（allP〈 0.05）. Multivariate analyses revealed that inferior Child-Pugh classification（grade B）, absence of tumoral capsule integrity, and advanced TNM stage were independent prognostic factors for poor OS. Conclusions Tumor capsule integrity, TNM stage,and Child-Pugh classification are associated with OS of patients with HCC. Integrity evaluation of tumoral capsule and its prognostic implications should be given full attention for both pathologists and clinicians.

关 键 词：肝细胞癌 预后 总生存 

分 类 号：R735.7[医药卫生—肿瘤]