肝切除术联合淋巴结清扫治疗原发性肝癌预后及其影响因素分析  

Analysis of prognosis and influencing factors of primary liver cancer treated with hepatectomy combined with lymph node dissection

作　　者：张建[1] 王锦祥[1] 李晓辉[1] ZHANG Jian;WANG Jinxiang;LI Xiaohui(Surgery Department Ⅱ,Puning People’s Hospital,Guangdong,Puning 515300,China)

机构地区：[1]广东省普宁市人民医院外二科,广东普宁515300

出　　处：《中国医药科学》2024年第2期150-153,共4页China Medicine And Pharmacy

基　　金：广东省揭阳市科技计划项目(ylxm081)。

摘　　要：目的探讨肝切除术联合淋巴结清扫治疗原发性肝癌预后及其影响因素分析。方法分析2018年10月至2022年5月普宁市人民医院收治60例经病理证实为原发性肝癌患者,进行病理特征及治疗等指标分析,并分析这些指标对生存率、无瘤生存率的影响。结果术后进行随访1年显示,本研究中所选取的患者半年和1年的无瘤生存率为46.2%(24/52)、26.9%(14/52);单因素分析显示,发现方式、肿瘤直径、肿瘤TNM分期、根治分类、有无输血情况、复发与治疗、门静脉癌栓、病灶数量、肝硬化及淋巴结是否清扫均为影响原位性肝癌患者预后的因素(P<0.05);多因素分析显示,肿瘤直径、淋巴结清扫、根治分类、复发与治疗是术后生存率的影响因素(P<0.05),肝硬化类型、输血是无瘤生存率的影响因素(P<0.05)。结论复发后再手术切除、根治分类、淋巴结清扫及肿瘤直径为影响原发性肝癌患者的预后的独立危险因素,围手术期输血、肝硬化严重程度与无瘤生存率存在一定的关系。Objective To investigate the prognosis and influencing factors of hepatectomy combined with lymph node dissection for primary liver cancer.Methods 60 patients with pathologically confirmed primary liver cancer admitted to Puning People’s Hospital from October 2018 to May 2022 were analyzed,and the pathological characteristics and treatment indexes were analyzed,and the effects of these indexes on the survival rate without cancer were analyzed.Results The 1-year follow-up showed that the 6-month and 1-year survival rates of the patients selected in this study were 46.2%(24/52)and 26.9%(14/52)respectively.Univariate analysis showed that factors such as discovery method,tumor diameter,TNM staging,radical classification,presence or absence of blood transfusion,recurrence and treatment,portal vein tumor thrombus,number of lesions,liver cirrhosis,and lymph node dissection were all factors affecting the prognosis of patients with primary liver cancer(P<0.05).Multivariate analysis showed that tumor diameter,lymph node dissection,radical classification,recurrence,and treatment were influencing factors for postoperative survival rate(P<0.05),while liver cirrhosis type and blood transfusion were influencing factors for tumor-free survival rate(P<0.05).Conclusion Surgical resection,radical classification,lymph node dissection,and tumor diameter are independent risk factors that affect the prognosis of patients with primary liver cancer after recurrence.There is a certain relationship between perioperative blood transfusion,severity of liver cirrhosis,and tumor-free survival rate.

关 键 词：肝切除术 淋巴结清扫 原发性肝癌 预后 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]