国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (3): 172-176.doi: 10.3760/cma.j.issn.1673422X.2015.03.004

• 论著 • 上一篇    下一篇

影响肝癌切除术预后的多因素分析

斯迪克江依布拉音, 刘洪亮, 吴晓龙, 赵亚杰, 吉冉, 陈义发   

  1. 430030武汉，华中科技大学同济医学院附属同济医院肝脏外科中心
  • 出版日期:2015-03-08 发布日期:2015-01-29
  • 通讯作者: 陈义发，Email：yfchen@tjh.tjmu.edu.cn E-mail:yfchen@tjh.tjmu.edu.cn

Multivariate analysis of factors influencing hepatocellular carcinoma prognosis after hepatectomy

Sidi kejiang·Yibulayin, Liu Hongliang, Wu Xiaolong, Zhao Yajie, Ji Ran, Chen Yifa   

  1.  Department of Hepatic Surgery Center, Tongji Hospital Affiliated to Tongji Medical College, Hua Zhong University of Science & Technology, Wuhan 430030, China
  • Online:2015-03-08 Published:2015-01-29
  • Contact: Chen Yifa E-mail:yfchen@tjh.tjmu.edu.cn

PDF

1316

被引次数

5

摘要： 目的回顾性研究肝硬化、ChildPugh分级、肿瘤大小、门脉癌栓、术中输血、肝门阻断时间等与肝癌切除术预后的关系。方法回顾性分析2007—2009年华中科技大学同济医学院附属同济医院进行肝癌切除术的123例原发性肝癌患者临床资料，用LogRank检验和Cox风险比例模型分析肝癌切除术预后的相关危险因素。结果患者术后1、2、3、5年复发率分别为54.17%、66.67%、81.40%、87.50%，平均复发时间为19.5个月。1、2、3、5年生存率分别为93.50%、73.17%、58.54%、27.64%，平均生存时间为42.9个月。单因素分析显示肝硬化（χ2=11.159，P=0.005）、ChildPugh分级（χ2=7.715，P=0.028）、肿瘤≥5 cm（χ2=11.483，P=0.004）、门脉癌栓（χ2=22.271，P=0.001）与肝癌复发有关；多因素分析显示肝硬化（χ2=8.993，P=0.003）、肿瘤≥5 cm（χ2=4.022，P=0.039）、门脉癌栓（χ2=5.023，P=0.027）与肿瘤复发有关。单因素分析显示肝硬化（χ2=7.339，P=0.025）、血清甲胎蛋白AFP＞400 ng/ml（χ2=5.431，P=0.042）、ChildPugh分级（χ2=13.389，P=0.002）、肿瘤≥5 cm（χ2=11.342，P=0.003）、门脉癌栓（χ2=52.167，P＜0.001）、肝门阻断（χ2=5.801，P=0.037）、术中输血（χ2=14.959，P=0.001）等与患者术后生存率有关；多因素分析显示肝硬化（χ2=9.133，P=0.003）、ChildPugh分级（χ2=4.799，P=0.028）、肿瘤≥5 cm（χ2=9.101，P=0.004）、门脉癌栓（χ2=11.126，P=0.001）、肝门阻断（χ2=3.985，P=0.046）与患者术后生存率相关。结论肝硬化、ChildPugh分级、肿瘤大小≥5 cm、门脉癌栓、肝门阻断是影响肝癌患者切除术预后的独立因素。

关键词: 肝肿瘤, 预后, 危险因素

Abstract: ObjectiveTo retrospectively study the relationship between several risk factors such as cirrhosis, ChildPugh classification, tumor size, portal vein tumor thrombus, intraoperative transfusion, hepatic portal occlusion time and the prognosis of hepatic cellular cancer (HCC) patients after hepatic resection. MethodsThe clinical data of 123 patients who received hepatic resection for HCC at Tongji Hospital between 2007 and 2009 were retrospectively analyzed. LogRank test and Cox proportional hazard model were used in the univariate and multivariate analyses of risk factors. Results1, 2, 3, 5 year recurrence and survival rates were 54.17%, 66.67%, 81.40%, 87.50% and 93.50%, 73.17%, 58.54%, 27.64%, respectively. The mean recurrence time and survival time were 19.5 months and 42.9 months. In univariate analysis, presence of cirrhosis (χ2=11.159, P=0.005), ChildPugh classification (χ2=7.715, P=0.028), tumor size (≥5cm) (χ2=11.483，P=0.004), presence of portal vein invasion (χ2=22.271, P=0.001) were risk factors affecting HCC recurrence. In multivariate analysis, presence of cirrhosis (χ2=8.993, P=0.003), tumor size (≥5cm) (χ2=4.022, P=0.039), presence of portal vein invasion (χ2=5.023, P=0.027) were independent risk factors affecting HCC recurrence. In univariate analysis, presence of cirrhosis (χ2=7.339，P=0.025), AFP>400 ng/ml (χ2=5.431，P=0.042), ChildPugh classification (χ2=13.389, P=0.002), tumor size(≥5cm) (χ2=11.342，P=0.003), presence of portal vein invasion (χ2=52.167, P＜0.001), hepatic portal occlusion (χ2=5.801, P=0.037), intraoperative blood transfusion (χ2=14.959, P=0.001) were risk factors affecting a shorter overall survival. In multivariate analysis, presence of cirrhosis (χ2=9.133, P=0.003), ChildPugh classification (χ2=4.799, P=0.028), tumor size (≥5 cm) (χ2=9.101, P=0.004), presence of portal vein invasion (χ2=11.126, P=0.001), hepatic portal occlusion (χ2=3.985, P=0.046) were independent prognostic factors affecting shorter overall survival. ConclusionCirrhosis, ChildPugh classification, tumor size (≥5 cm), presence of portal vein invasion, and hepatic portal occlusion were independent prognostic factors for HCC patients after hepatic resection.

Key words: Liver neoplasms, Prognosis, Risk factors