手术治疗原发性肝癌患者生存率的影响因素分析  

Analysis of Factors Affecting Survival Rate of Operation for Primary Liver Carcinoma

作　　者：王钢[1] 赵利锋[1] 雷达[1] 杨彦伟[1] 

机构地区：[1]陕西省宝鸡市中心医院,721008

出　　处：《实用癌症杂志》2015年第4期606-608,612,共4页The Practical Journal of Cancer

摘　　要：目的探讨原发性肝癌(PLC)手术治疗后生存率的影响因素。方法选取行肝癌手术切除治疗的PLC患者186例,随访患者生存率,统计影响患者预后的主要因素。结果 186例患者均获随访,随访时间为7~84个月,中位随访时间41.5个月;随访生存时间8~92个月,中位生存期为51.2个月;患者1年、3年及5年总生存率分别为83.4%、68.4%及38.7%;患者1年、3年及5年无复发生存率分别为65.5%、32.6%及20.5%。肝硬化、肿瘤大小≥5cm、术前甲胎蛋白水平>400 ng/m L、甲胎蛋白术前术后变化、血管侵犯、辅助治疗方式及PLC家族史是影响患者预后的危险因素(P均<0.05)。肝硬化、血管侵犯及甲胎蛋白术前术后变化是影响PLC患者治疗预后的独立危险因素(P均<0.05)。结论 PLC术后生存率的影响因素较多,临床应综合考虑,对于高危患者应定期随访,及早诊断和治疗,以改善患者的预后。Objective To explore the factors affecting survival rate of operation for primary liver carcinoma(PLC).Methods 186 cases of patients with PLC treated by operation resection were chosen for the study,survival rate and the main factors affecting the prognosis were analyzed during the follow-up.Results 186 patients received followed up,the follow-up time was7 ~ 84 months,and the median follow-up time was 41.5 months.The follow-up survival time was 8 ~ 92 months,the median survival time was 51.2 months.The 1-,3-and 5-year overall survival rates were 83.4%,68.4% and 38.7%,and the 1-,3-and 5-year relapse free survival rates were 65.5%,32.6% and 20.5%.Liver cirrhosis,tumor size(≥5 cm),preoperative alpha fetoprotein level(> 400 ng/m L),alpha fetoprotein(AFP) preoperative and postoperative changes,vascular invasion,auxiliary treatment and family history of PLC were risk factors affecting prognosis(all P < 0.05).Cirrhosis of the liver,vascular invasion and AFP preoperative and postoperative changes were the independent prognostic factors for patients with PLC(all P < 0.05).Conclusion There are many factors affecting the postoperative survival rate of PLC patients,all factors should be considered in clinical.For high-risk patients,the follow-up should be conducted regularly,and early diagnosis and treatment can improve the prognosis of the patients.

关 键 词：原发性肝癌 手术 生存率 因素 

分 类 号：R735.7[医药卫生—肿瘤]