肝细胞癌切除术后预后因素分析

目的探索影响肝细胞肝癌手术预后的因素。方法回顾性分析2000～2005年76例经病理证实的肝细胞肝癌手术切除患者,选择16项临床、病理学因素,分析其对生存率的影响。结果全组1,3,5年生存率分别为85.53%,48.05%,14.96%。60例获得根治者1,3,5年生存率分别为100%,58.93%和18.35%。影响预后的单因素为:肿瘤根治程度、肝癌结节数目、肝功能分级、肿瘤分期、门脉癌栓、术前血清胆红素、术前白蛋白水平。多因素分析表明:术前肝功能Child-Pugh分级、肿瘤结节数目、门脉癌栓和肿瘤根治程度与生存率有显著相关性。结论肿瘤结节数目、门脉癌栓、术前肝功能分级、肿瘤根治程度是影响肝细胞肝癌术后的高风险因素。

Analysis on prognostic factors of hepatocellular carcinoma patients after hepatectomy

Objective To explore the prognostic factors of hepatocellular carcinoma(HCC) patients after hepatectomy.Methods From January 2000 to December 2005,76 patients who underwent hepatectomy for HCC were enrolled for reviewing their clinical characteristics,treatment and prognosis.Sixteen parameters contributing to survival rate(SR) were analysed.Results The 1,3,5 years cumulative SR of the whole group was 85.53%,48.05% and 14.96%,respectively.The 1,3,5 years SR in the curative resection(CR) group(n=60) were 100%,58.93% and 18.35%,respectively.Results showed that hepatic functional classification,tumor numbers,portal tumor thrombi,tumor stage,blood-serum bilirubin,blood-serum albumin and CR were risk factors by univariate analysis;A multivariable analysis showed that CR,tumor numbers,portal tumor thrombi and hepatic functional classification were independent prognostic factors.Conclusion Curative resection,tumor numbers,portal tumor thrombi and hepatic functional classification are important risk factors for prognosis on HCC patients after hepatectomy.