肝细胞癌根治性肝切除术后患者生存预后分析  

Survival prognostic analysis in patients with hepatocellular carcinoma after radical resection

作　　者：陈郁珊[1] 陈慕瑶[2] 麦苗青[1] 陈佩芬[1] 胡莲英[1] 

机构地区：[1]中山大学附属肿瘤防治中心放疗科,广州510080 [2]中山大学附属第一医院麻醉科,广州510080

出　　处：《中华肝脏外科手术学电子杂志》2015年第1期35-37,共3页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨肝细胞癌（肝癌）根治性肝切除术后患者生存预后的影响因素。方法回顾性分析2006年1月至2012年6月在中山大学肿瘤防治中心行根治性肝切除术的1 102例肝癌患者临床资料。其中男872例,女230例;平均年龄（55±15）岁。所有患者均签署知情同意书,符合医学伦理学规定。患者术后接受随访,根据随访结果,采用Kaplan-Meier法计算患者的累积生存率。将患者年龄、性别、乙型病毒性肝炎（乙肝）病史、肝癌家族史、血清AFP、血清ALP、肝功能Child-Pugh分级、肿瘤直径、门静脉癌栓、肿瘤分化程度、血管浸润、淋巴结转移、远处转移、肿瘤TNM分期等临床参数纳入影响预后因素。对影响预后的因素进行Log-rank检验单因素分析和Cox比例风险回归模型多因素分析。结果肝癌根治性肝切除患者术后生存时间为4-114个月,中位生存时间70个月;其1、3、5年累积生存率分别为88.9%、73.2%、52.3%。肿瘤直径〉4 cm、血清AFP阳性、肿瘤低分化是影响肝癌根治性肝切除术后患者预后的独立危险因素（RR=1.951,3.498,3.781;P〈0.05）。结论肿瘤直径〉4 cm、血清AFP阳性、肿瘤低分化是影响肝癌根治性肝切除术后患者预后的独立危险因素。Objective To investigate the survival prognostic influencing factors of patients with hepatocellular carcinoma（HCC） after radical resection. Methods Clinical data of 1 102 patients with HCC undergoing radical resection in Sun Yat-sen University Cancer Center from January 2006 to June 2012 were analyzed retrospectively. There were 872 males and 230 females with a mean age of（55±15） years old. The informed consents of all patients were obtained and local ethical committee approval had been received. All the patients were followed up after operation. The cumulative survival rate was estimated using Kaplan-Meier method according to the follow-up results. Clinical indexes such as age, gender, history of viral hepatitis B, family history of HCC, serum alpha fetoprotein（AFP）, serum alkaline phosphatase（ALP）, Child-Pugh liver function grading, tumor diameter, portal vein tumor thrombus, tumor differentiation, vessel invasion, lymph node metastasis, distant metastasis, tumor node metastasis（TNM） staging were enrolled as prognostic impact factors and were analyzed using Log-rank test and Cox proportional hazards model. Results The survival time was 4-114 months with a median of 70 months for the patients with HCC after radical resection. The 1-, 3-, 5-year cumulative survival rates were 88.9%, 73.2%, 52.3%. Tumor diameter〉 4 cm, positive serum AFP, poor tumor differentiation were the independent risk factors for the prognosis of patients with HCC after radical resection（RR=1.951, 3.498, 3.781; P〈0.05）. Conclusion Tumor diameter〉 4 cm, positive serum AFP, poor tumor differentiation are the independent risk factors influencing the prognosis of patients with HCC after radical resection.

关 键 词：癌 肝细胞 肝切除术 预后 

分 类 号：R735.7[医药卫生—肿瘤]