原发性肝癌手术预后影响因素分析  

Analysis of prognostic factors of primary hepatic cancer after surgery

作　　者：钱波[1] 万圣云[1] 喻宗繁[1] 贾犇黎[1] 耿小平[1] 

机构地区：[1]安徽医科大学第二附属医院普通外科,合肥230601

出　　处：《安徽医科大学学报》2015年第10期1479-1482,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生厅医学科研重点项目(编号:2010A009);安徽省自然科学基金青年项目(编号:1308085QH152)

摘　　要：目的 探讨影响肝癌手术预后的相关因素. 方法回顾性分析89例肝癌患者的临床资料,对其预后影响因素进行单因素和多因素统计学分析. 结果 单因素分析结果显示：门脉癌栓、肝门阻断和肿瘤直径是肝癌患者无复发生存期（ RFS）相关的危险因素,不规则肿瘤切除、术后甲胎蛋白（AFP）转阴和术后肝动脉栓塞（TACE）治疗是RFS的保护因素;门脉癌栓、肝门阻断、肿瘤直径、肿瘤自发破裂和AFP半衰期是患者总体生存期（ OS）的危险因素,不规则肿瘤切除和术后AFP转阴是OS的保护因素;多因素分析结果显示：门脉癌栓、术后AFP未转阴和术后未行TACE治疗是影响RFS的独立危险因素（ OR=2. 437、0. 263、0. 312, 95%CI：1. 033-5. 752、0. 111-0. 628、0. 116 -0. 844,P〈0. 05）;术后AFP未转阴是影响OS的独立危险因素（ OR=0. 203, 95%CI：0. 085-0. 482,P〈0. 01）. 结论 肿瘤直径大、门脉癌栓、自发破裂、肝门阻断和AFP半衰期长的肝癌患者预后较差,术后AFP未转阴是影响RFS和OS的独立危险因素.Objective To identify the prognostic factors for primary hepatic cancer patients after surgery. Methods The clinical data of 89 primary hepatic cancer patients were analyzed retrospectively. The prognostic factors were analyzed by using univariate and multivariate analysis. Results Univariate analysis showed that portal vein tumor thrombus, hepatic portal occlusion, diameter of tumor were risk factors for recurrence-free survival（ RFS） . The ir-regular tumor resection, postoperative AFP negative, and TACE were protective factors for RFS. The portal vein tumor thrombus, hepatic portal occlusion, diameter of tumor, spontaneous rupture of the tumor, AFP half-life peri-od were risk factors for overall survival（ OS） . The irregular tumor resection, postoperative AFP negative were pro-tective factors for OS. Multivariate analysis showed that portal vein tumor thrombus, postoperative AFP negative, TACE were independent prognostic factors for RFS（OR=2. 437,0. 263,0. 312, 95%CI：1. 033-5. 752,0. 111-0. 628,0. 116-0. 844, P〈0. 05） and postoperative AFP negative was independent prognostic factor for OS（OR=0. 203, 95%CI：0. 085-0. 482, P〈0. 01）. Conclusion The prognosis of patients with big diameter of tumor, portal vein tumor thrombus, spontaneous rupture, hepatic portal occlusion, longer AFP half-life period is poor. The postoperative AFP negative is the independent risk factor both for the RFS and OS.

关 键 词：原发性肝癌 门脉癌栓 自发破裂 肝门阻断 

分 类 号：R735.7[医药卫生—肿瘤]