肝癌根治性切除术后患者复发情况及其危险因素分析  

Analysis of postoperative recurrence and risk factors of patients with liver cancer after radical resection

作　　者：薛慧敏 陈涛 朱校均 XUE Huimin;CHEN Tao;ZHU Xiaojun(General Surgery,the Affiliated Hospital of Nantong University,Nantong,Jiangsu,226000;Medical School of Nantong University,Nantong,Jiangsu,226000)

机构地区：[1]南通大学附属医院普通外科,江苏南通226000 [2]南通大学医学院,江苏南通226000

出　　处：《实用临床医药杂志》2022年第18期35-38,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨肝癌根治性切除术后患者的复发情况及其危险因素。方法回顾性分析2019年1月—2021年1月南通大学附属医院收治的304例肝癌根治性切除术后患者的临床资料,根据1年内是否复发将患者分为复发组和未复发组。统计肝癌根治性切除术后患者的复发情况,并采用单因素分析、多因素Logistic回归分析法分析肝癌根治性切除术后患者复发的危险因素。结果304例肝癌根治性切除术后患者随访1年内复发61例,复发率为20.07%。单因素分析结果显示,复发组与未复发组在肿瘤直径、肿瘤数目、有无肿瘤包膜浸润、有无血管侵犯、肿瘤包膜情况、术前血清甲胎蛋白(AFP)水平方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,肿瘤直径≥5 cm、肿瘤数目≥2个、有肿瘤包膜浸润、有血管侵犯、肿瘤包膜不完整、术前血清AFP水平≥400 ng/mL均为肝癌根治性切除术后患者复发的独立危险因素(OR=3.411、3.313、3.834、4.092、3.235、3.408,P<0.05)。结论肝癌根治性切除术后患者的复发率较高,危险因素包括肿瘤直径≥5 cm、肿瘤数目≥2个、有肿瘤包膜浸润、有血管侵犯、肿瘤包膜不完整、术前血清AFP水平≥400 ng/mL等,临床可对具有以上特征的患者进行针对性干预,以预防肝癌根治性切除术后患者病情复发。Objective To investigate the postoperative recurrence and risk factors of patients with liver cancer after radical resection.Methods The clinical data of 304 patients with liver cancer after radical resection who were treated in the Affiliated Hospital of Nantong University from January 2019 to January 2021 were retrospectively analyzed,the patients were divided into recurrence group and non-recurrence group according to whether they recurred within 1 year of follow-up.The recurrence conditions of patients with liver cancer after radical resection were recorded,and the risk factors of recurrence of patients with liver cancer after radical resection were analyzed by univariate analysis and multivariate Logistic regression analysis.Results Of 304 patients with liver cancer after radical resection,61 cases recurred within 1 year of follow-up,and the recurrence rate was 20.07%.There were significant differences between the recurrence group and the non-recurrence group in terms of tumor diameter,the number of tumors,existence of tumor capsular infiltration and vascular invasion,tumor capsule,andpreoperative level of serum alpha-fetoprotein(AFP)(P<0.05).The results of multivariate Logistic regression analysis showed that tumor diameter≥5 cm,the number of tumors≥2,tumor capsule invasion,vascular invasion,incomplete tumor capsule,and preoperative level of serum AFP≥400 ng/mL were all independent risk factors for recurrence of patients with liver cancer after radical resection(OR=3.411,3.313,3.834,4.092,3.235,3.408,P<0.05).Conclusion The recurrence rate of patients after radical resection of liver cancer is high,and its risk factors include tumor diameter≥5 cm,the number of tumors≥2,tumor capsule invasion,vascular invasion,incomplete tumor capsule and preoperative level of serum AFP≥400 ng/mL,etc.,clinical treatment and intervention could be carried out for patients with the above characteristics to prevent the recurrence of patients with liver cancer after radical resection.

关 键 词：原发性肝癌 肝癌根治性切除术 复发 甲胎蛋白 危险因素 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]