肝癌根治术治疗原发性肝癌患者的术后生存率及预后影响因素分析  

Analysis of postoperative survival rate and the prognostic factors of primary liver cancer patients after radical resection

作　　者：谭妮 郑海平[2] 欧超[1] Tan Ni;Zheng Haiping;Ou Chao(Department of Clinical Laboratory Medicine,the Affiliated Tumor Hospital of Guangxi Medical University,Guangxi Nanning 530021,China;Department of Oncology,the First Affiliated Hospital of Guangxi Medical University,Guangxi Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院检验科,广西南宁530021 [2]广西医科大学第一附属医院肿瘤内科,广西南宁530021

出　　处：《现代肿瘤医学》2019年第5期826-829,共4页Journal of Modern Oncology

基　　金：广西自然科学基金(编号:2017GXNSFAA198015);广西医疗卫生适宜技术开发与推广应用项目(编号:S2017104)

摘　　要：目的:探讨肝癌根治术治疗原发性肝癌(PHC)患者的术后生存率及预后影响因素。方法:回顾性分析2007年1月至2012年9月我院行肝癌根治术治疗的401例原发性肝癌患者术后临床资料及随访数据,通过电话、门诊复诊等方式进行随访。采用Kaplan-Meier法对变量进行生存分析,绘制生存曲线和计算生存率,采用Log-rank法进行单因素分析,采用Cox回归模型进行多因素分析。结果:随访截至2013年2月6日,401例患者失访34例(8. 5%),中位生存时间为53个月,1年生存率为86. 9%,3年生存率为58. 5%,5年生存率为39. 0%。单因素分析表明前白蛋白(PA)、谷草转氨酶(AST)、白蛋白(ALB)、甲胎蛋白(AFP)为肝癌根治术后预后的危险因素,多因素分析显示肝癌根治术后AFP为影响预后的独立危险因素。结论:血清PA、AST、ALB是原发性肝癌根治术后预后的危险因素,血清AFP是预后独立危险因素,临床应该加强随访,定期监测患者血清PA、AST、ALB、AFP水平,及时治疗,以改善患者预后及提高生活质量。Objective:To investigate the postoperative survival rate and prognostic factors of primary hepatocellular carcinoma(PHC)treated by radical surgery.Methods:Clinical data and follow-up data of 401 patients with primary liver cancer who underwent radical surgery in our hospital from January 2007 to September 2012 were retrospectively analyzed.Follow-up visits were conducted through telephone and outpatient visits.The Kaplan-Meier method was used to analyze the survival of the variables,draw the survival curve and calculate the survival rate.The Log-rank method was used for single factor analysis,and the Cox regression model was used for multivariate analysis.Results:Final time of follow-up was February 6,2013.34 patients were lost in 401 patrents(8.5%).Median survival time was 53 months.1-year survival rate was 86.9%.3-year survival rate was 58.5%.5-year survival rate was 39.0%.Univariate analysis showed that prealbumin(PA),aspartate aminotransferase(AST),serum albumin(ALB),andα-fetoprotein(AFP)were risk factors after liver cancer surgery.Multivariate analysis showed that postoperative AFP in patients undergoing radical resection of liver cancer was an independent risk factor for prognosis.Conclusion:There are many factors affecting the survival rate and prognosis of primary hepatocellular carcinoma after surgery.Serum levels of PA,AST,ALB and AFP should be monitored regularly to improve the prognosis and quality of life.

关 键 词：原发性肝癌 根治术 生存率 预后影响因素 

分 类 号：R735.7[医药卫生—肿瘤]