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作 者:陈晹 万来忆 朱益军[2] 李叶晟 刘娇 张猛 曾东[3] 冯艳玲[3] 黄杨卿[1] CHEN Yi;WAN Laiyi;ZHU Yijun;LI Yesheng;LIU Jiao;ZHANG Meng;ZENG Dong;FENG Yanling;HUANG Yangqing(Department of Hepatobiliary Surgery,Shanghai Public Health Clinical Center,Shanghai 201508,China;Department of Thoracic Surgery,Shanghai Public Health Clinical Center,Shanghai 201508,China;Department of Pathology,Shanghai Public Health Clinical Center,Shanghai 201508,China)
机构地区:[1]上海市公共卫生临床中心肝胆外科,上海201508 [2]上海市公共卫生临床中心胸外科,上海201508 [3]上海市公共卫生临床中心病理科,上海201508
出 处:《肝胆胰外科杂志》2022年第9期519-525,共7页Journal of Hepatopancreatobiliary Surgery
摘 要:目的回顾性分析合并人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染肝细胞癌(hepatocellular carcinoma,HCC)患者的临床特征及肝切除术预后。方法上海市公共卫生临床中心2014年6月至2021年12月33例合并HIV感染肝细胞癌肝切除术患者的临床资料纳入研究,总结分析临床特征、预后及影响预后的危险因素。结果中位随访时间36个月,全部患者的中位无瘤生存时间及中位总生存时间分别为10个月和未达到。影响无瘤生存及总生存的危险因素分别为:肿瘤最大径≥5 cm、肿瘤多发、门静脉癌栓、微血管癌栓、肿瘤分期、出血量≥1000 mL及大部肝切除。结论合并HIV感染的HCC患者起病更早,肿瘤分期靠前,总体肝切除预后与阴性患者相当;具有高危复发危险因素的患者,应加强临床研究,探索更为有效的围术期治疗方案,以期进一步提高疗效。Objective The clinical features and prognosis of hepatectomy for hepatocellular carcinoma(HCC)patients complicated with human immunodeficiency virus infection(HIV)were retrospectively analyzed.Methods 33 cases of HIV-HCC patients accepted hepatectomy from Jun.2014 to Dec.2021 in Shanghai Public Health Clinical Center were collected.All patients were recruited into this study and analyzed their clinical characteristics,prognosis and risk factors related to prognosis.Results Median follow-up time was 36 months.Median disease free survival(DFS)and overall survival(OS)were 10 months and not evaluated(NE),respectively.Risk factors related to DFS and OS were tumor diameter≥5 cm,multiple tumors,portal vein tumor thrombus,microvascular invasion,tumor stage,bleeding volume≥1000 m L and major hepatectomy.Conclusion HCC patients with HIV infection had earlier onset and advanced tumor stage,and the overall prognosis of hepatectomy was similar to that of negative patients.For patients with high risk factors of recurrence,clinical studies should be strengthened to explore more effective perioperative treatment plans in order to further improve the efficacy.
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