巨大肝癌手术疗效及影响预后的因素分析  

Analysis of Surgical Efficacy and Factors Affecting Postoperative Prognosis of Huge Hepatocellular Carcinoma

作　　者：耿广勇[1] 王文斌[1] 陆震[1] 袁笑[1] 徐阿曼[2] 刘付宝[2] GENG Guang-yong;WANG Wen-bin;LU Zhen(Department of General Surgery,The Fourth Affiliated Hospital of Anhui Medical Univer-sity,Hefei 230012,China)

机构地区：[1]安徽医科大学第四附属医院普通外科,合肥230012 [2]安徽医科大学第一附属医院普通外科

出　　处：《肝胆外科杂志》2022年第3期190-194,共5页Journal of Hepatobiliary Surgery

基　　金：国家和省级重点专科建设计划(项目编号:Z155080000004);安徽医科大学第四附属医院科研培育基金(项目编号:2021YKJ003)。

摘　　要：目的 本文旨在探讨巨大肝癌根治性切除术后的临床疗效及其预后影响因素。方法 回顾性分析2016—2018年间75例行根治性切除术的巨大肝细胞癌(huge hepatocellular carcinoma)连续性患者的临床、病理及生存资料。应用Cox比例风险回归模型来进行影响生存的单因素及多因素分析。结果 75例患者中,男性64例(85.3%),女性11例(14.7%),中位年龄52岁(范围:26~77岁),随访时间为7~71个月,到随访截止时间,49例患者死亡。1、3年总体生存率分别为72.0%、41.3%。单因素分析显示,年龄(HR=0.97, 95%CI:0.94~1.00,P=0.020)、MVI(HR=1.93, 95%CI:1.00~3.70,P=0.049)、AFP水平(HR=1.00, 95%CI:1.00~1.00,P<0.001)是影响巨大肝癌患者术后总生存期的预测因子。多因素分析显示,MVI(HR=2.58, 95%CI:1.31~5.10,P=0.006)、AFP水平(HR=1.00, 95%CI:1.00~1.00,P<0.001)是巨大肝癌患者术后总生存期的独立预测因子。结论 MVI、AFP水平对巨大肝癌患者术后总生存期具有一定的预测作用。Objective To investigate the clinical efficacy and prognostic factors of radical huge hepatocellular carcinoma resection. Methods The clinical, pathological and survival data of 75 consecutive patients undergoing radical resection of huge hepatocellular carcinoma from 2016 to 2018 were retrospectively analyzed. Cox proportional risk regression model was used to analyze univariate and multivariate factors affecting survival. Results Among the 75 patients, 64 were male(85.3%) and 11 were female(14.7%), with a median age of 52 years(range: 26~77 years). The follow-up period was 7~71 months, and 49 patients died by the end of follow-up. The overall 1-year and 3-year survival rates were 72.0% and 41.3%, respectively. Univariate analysis showed that age(HR=0.97, 95% CI: 0.94~1.00, P=0.020), MVI(HR=1.93, 95% CI: 1.00~3.70, P=0.049) and AFP level(HR=1.00, 95% CI: 1.00~1.00, P<0.001) were predictors of postoperative overall survival in patients with huge hepatocellular carcinoma. However, multivariate analysis showed that MVI(HR=2.58, 95% CI: 1.31~5.10, P=0.006) and AFP level(HR=1.00, 95% CI: 1.00~1.00, P<0.001) were independent predictors of overall survival in patients with huge hepatocellular carcinoma. Conclusion MVI and AFP levels can predict the overall survival of patients with huge hepatocellular carcinoma.

关 键 词：巨大肝癌 肝切除术 预后 存活率分析 

分 类 号：R735.7[医药卫生—肿瘤]