原发性肝癌患者手术治疗远期疗效的影响因素  

Factors Influencing Long-term Effect of Surgical Treatment for Primary Liver Cancer

作　　者：王伟[1] 葛瑞良[1] 胡雷[1] 王义[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院,200438

出　　处：《实用癌症杂志》2014年第6期678-680,共3页The Practical Journal of Cancer

摘　　要：目的探讨原发性肝癌患者手术治疗远期疗效的影响因素。方法 413例原发性肝癌并行肝部分切除术患者,剔除失访的41例后,对其余372例患者的远期生存状况进行观察,并对其相关影响因素进行分析。结果 5年生存率为14.78%(55/372),余317例死亡患者,根据术后是否存在复发转移分为复发转移组(n=194)与非复发转移组(n=123)。两组患者在有无乙肝及肝硬化、肿瘤大小、包膜完整与否、分化程度、是否存在血管癌栓及多结节融合等方面相对比,差异均有统计学意义(P<0.05);两组患者在术中出血量、输血情况、手术时间及肝门阻断时间、手术切缘、是否存在血管侵犯及肿瘤破裂等方面比较,差异并无统计学意义(P>0.05)。经Logistic回归分析发现,乙肝、肝硬化、肿瘤大小、包膜完整与否、分化程度、多结节融合及血管癌栓是否存在,为影响原发性肝癌患者术后复发转移的独立危险因素(P<0.05)。结论复发转移是影响患者远期生存状况的重要因素,而乙肝、肝硬化、肿瘤大小、包膜完整与否、分化程度、多结节融合及血管癌栓是否存在,为影响原发性肝癌患者术后复发转移的独立危险因素。Objective To investigate the influencing factors of long-term effect of surgical treatment for primary liver cancer. Methods 413 cases of primary liver cancer patients were treated with partial liver resection. Of the 413 patients,41 defaulting patients were excluded,and long-term survival of the remaining 372 patients was observed,and its related factors were analyzed. Results 5-year survival rate was 14. 78%( 55 /372). The remaining 317 cases of patients who died after surgery,according to the presence of metastatic recurrence were divided into recurrence group( n = 194) and non-recurrence group( n = 123).Two groups in hepatitis,cirrhosis,tumor size,encapsulated or not,differentiation,integration of multiple nodules and vascular thrombosis exists were compared,the differences were statistically significant( P < 0. 05); Two groups in blood loss,transfusion cases,surgery time and hilar occlusion time,surgical margin,whether vascular invasion and tumor rupture were compared,the differences were not statistically significant( P > 0. 05). Logistic regression analysis showed that hepatitis,cirrhosis,tumor size,encapsulated or not,differentiation,integration of multiple nodules and vascular thrombosis were independent risk factors of recurrence and metastasis in patients with primary liver cancer( P < 0. 05). Conclusion Recurrence and metastasis is an important factor affecting long-term survival of patients. Hepatitis,cirrhosis,tumor size,encapsulated or not,differentiation,integration of multiple nodules and vascular thrombosis are independent risk factors of recurrence and metastasis in patients with primary liver cancer.

关 键 词：原发性肝癌 肝部分切除术 远期生存状况 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]