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| 肝癌肝移植术后复发的危险因素分析 | |
| 引用本文： | 张荣生,王轩,张斌,李增才,江涛,陆雷,张冬华. 肝癌肝移植术后复发的危险因素分析[J]. 中国普外基础与临床杂志, 2011, 18(1): 29-32 |
| 作者姓名： | 张荣生 王轩 张斌 李增才 江涛 陆雷 张冬华 |
| 作者单位： | 解放军第八一医院肝移植中心肿瘤外科,江苏南京,210002 |
| 摘 要： | 目的探讨原发性肝癌(HCC)肝移植术后肿瘤复发或转移的危险因素。方法回顾性我院2003年4月至2007年11月期间76例HCC患者行肝移植的临床资料,根据随访期间是否有复发分为复发组(n=23)和未复发组(n=53),总结肿瘤复发的特点。结果 76例患者中23例(30.3%)术后复发。单因素分析显示患者性别(P=0.449)、年龄(P=0.091)、术前是否治疗(P=0.958)、肿瘤数目(P=0.212)和是否伴有HBV/HCV感染(P=0.220)与肿瘤的复发无关,而肿瘤包膜完整性(P=0.009)、肿瘤分期(P=0.002)、肿瘤直径(P<0.001)、血管侵犯(P<0.001)以及术前AFP水平(P=0.044)与肿瘤的复发有关,其中肿瘤直径<5.0 cm(P=0.001)和术后2个月AFP水平恢复正常者(P<0.001)1年复发率更低。多因素分析显示肿瘤直径(P=0.001,OR=6.456,95%CI为2.356～17.680)、血管侵犯(P=0.030,OR=10.653,95%CI为1.248～90.910)以及术前AFP水平(P=0.017,OR=2.601,95%CI为2.196～5.658)是肝移植术后肿瘤复发的独立危险因素。结论对于肿瘤直径>5.0 cm、伴有血管侵犯以及术前AFP水平≥400μg/L尤其术后2个月AFP水平仍高于正常者术后需加强监测,必要时尽早给予抗肿瘤治疗。 |
| 关 键 词： | 肝细胞肝癌 肝移植 复发 甲胎蛋白 肿瘤大小 |
Analysis of Risk Factors for Recurrence of Hepatocellular Carcinoma after Liver Transplantation |
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| ZHANG Rong-sheng,WANG Xuan,ZHANG Bin,LI Zeng-cai,JIANG Tao,LU Lei,ZHANG Dong-hua. Analysis of Risk Factors for Recurrence of Hepatocellular Carcinoma after Liver Transplantation[J]. Chinese Journal of Bases and Clinics In General Surgery, 2011, 18(1): 29-32 | |
| Authors: | ZHANG Rong-sheng WANG Xuan ZHANG Bin LI Zeng-cai JIANG Tao LU Lei ZHANG Dong-hua |
| Affiliation: | ZHANG Rong-sheng,WANG Xuan,ZHANG Bin,LI Zeng-cai,JIANG Tao,LU Lei,ZHANG Dong-hua.Department of Oncological Surgery,Center of Liver Transplantation of The 81st Hospital of PLA,Nanjing 210002,Jiangsu Province,China |
| Abstract: | Objective To determine the risk factors for recurrence of hepatocellular carcinoma(HCC) after orthotopic liver transplantation(OLT).Methods The clinical data from seventy-six consecutive HCC patients who underwent OLT were retrospectively analyzed.The patients were divided into non-recurrence group(n=53) and recurrence group(n=23) based on recurrence,and the characteristics of tumor recurrence were analyzed.Results The overall recurrence rate of tumor was 30.3%(23/76).By univariate analysis,gender(P=0.449),... |
| Keywords: | Hepatocellular carcinoma Liver transplantation Recurrence Alpha fetoprotein Tumor size |
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