原发性肝癌手术切除患者预后危险因素分析

目的：分析影响原发性肝癌患者手术切除后总体生存率和元瘤生存率的危险因素。方法：回顾性分析186例手术切除的肝癌患者临床和病理资料，Kaplan-Meier法和logrank检验进行单因素分析，应用Cox比例风险模型进行多因素分析。结果：影响思者总体预后的独立危险因素包括AFP水平、有无包膜、TNM分期、肿瘤分布、血管侵犯和围手术期输血；影响患者无瘤生存的独立危险因素包括性别、AFP水平、有无包膜、TNM分期、肿痛数目、肿瘤分布和围手术期输血。结论：肝癌手术切除患者预后与肿瘤进展程度以及围手术期大量输血有关。术前积极改善患者凝血功能，术中有效控制出血，减少输血对于改善患者预后可能有积极的作用．

Risk factors of estimating prognosis after hepatectomy for hepatocellular carcinoma

Objectlve：To analyze the risk prognostic factors affecting disease -free and overall survival of patients with hepatocellular carcinoma （HCC） after hepateetomy. Methods： The clinical and pathological data of 186 patients undergoing liver resection for hepatocellular carcinoma from January 1997 to January 2007 was retrospectively reviewed. The Kaplan - Meier method and log rank test were used to analyze univariate prognostic factors. The Cox proportional hazard model was used for multivariate analysis. Results： The significant risk factors for decreasing the over- all survival were AFP, tumor distribution, vascular invasion, capsule absent, TNM stage and blood transfusion. Independent risk factors associated with lower diseare- free survival were male gender, AFP, tumor number, tumor distribution, capsule absent, TNM stage and blood transfusion. Conclusion： The prognosis of the patients undergoing hepa- tectomy relies largely on tumor status and progression and perioperative blood transfusion. Readjusting clotting mechanism preoperatively, minimizing bleeding and blood transfusion in the operation could probably do great favor to the survival of patients.