原发性肝癌隐匿型破裂对患者术后预后的影响  

Effect of occult rupture of primary hepatocellular carcinoma on postoperative prognosis of patients

作　　者：孔杰 李辉[1] 袁玉斌 韩方征[2] 叶永强[1] KONG Jie;LI Hui;YUAN Yu-bin;HAN Fang-zheng;YE Yong-qiang(Department of Hepatobiliary Surgery,Heze Municiple Hospital,Heze,Shandong 274000,China;不详)

机构地区：[1]菏泽市立医院肝胆外科,山东菏泽274000 [2]菏泽市立医院病理科,山东菏泽274000

出　　处：《中国临床研究》2022年第4期498-502,共5页Chinese Journal of Clinical Research

基　　金：2021年菏泽市立医院科技发展计划项目(2021YN78)。

摘　　要：目的探讨原发性肝细胞癌(HCC)隐匿型破裂患者择期肝切除术后的预后。方法回顾性分析2006年1月至2016年9月于菏泽市立医院因原发性HCC接受择期肝切除397例患者的临床资料。结果隐匿型破裂HCC患者31例(7.8%,破裂组),无肿瘤破裂者366例(92.2%,非破裂组)。破裂组患者1、3和5年的总体生存率(46.7%、17.8%和15.2%),低于非破裂组(84.5%、53.3%和47.4%),差异有统计学意义(P<0.01);破裂组1、3和5年无瘤生存率(22.9%、15.2%和5.9%)低于非破裂组(71.4%、40.0%和35.5%),差异有统计学意义(P<0.01)。随访期间隐匿型破裂HCC患者26例死亡,死因为HCC相关复发者25例,肝病相关死亡1例。Cox回归模型分析示,非R0切除是影响隐匿型破裂HCC患者无瘤生存的独立危险因素[RR=5.464,95%CI(2.070~14.422),P<0.01]。结论隐匿型肿瘤破裂是HCC患者术后预后的重要影响因素,接受非R0切除的隐匿型破裂HCC术后无瘤生存较差。Objective To explore the prognosis of patients with the occult rupture of primary hepatocellular carcinoma(HCC)after elective hepatectomy.Methods A retrospective analysis was performed on the clinical data of 397 HCC patients receiving elective hepatectomy in Heze Municipal Hospital from January 2006 to September 2016.Results There were 31 patients(7.8%)with occult rupture of HCC(ruptured group)and 366 patients(92.2%)without occult rupture of HCC(unruptured group).The overall survival rates at 1-,3-and 5-year were 46.7%,17.8% and 15.2%,respectively in rupture group and were lower than those(84.5%,53.3% and 47.4%)in unruptured group(P<0.01).The disease-free survival(DFS)rates at 1-,3-and 5-year were 22.9%,15.2%,5.9%,respectively in ruptured group and were significantly lower than those(71.4%,40.0%,35.5%)in unruptured group(P<0.01).A total of 26 cases died in ruptured group,25 cases died of HCC related recurrence,and 1 case died of liver disease during follow-up period.Cox regression analysis showed that the non-complete resection(R0)was an independent risk factor for DFS in patients with occult ruptured HCC[RR=5.464,95%CI(2.070-14.422),P<0.01].Conclusion The occult tumor rupture is an important factor for HCC patients'prognosis after undergoing hepatectomy.The patients with occult ruptured HCC receiving non-R0 resection have poor DFS.

关 键 词：肝细胞癌 隐匿 破裂 复发 肝切除 预后 

分 类 号：R735.7[医药卫生—肿瘤]