超声检测肿瘤大小在肝细胞癌肝移植预后研究中的价值

目的 探讨超声检测肿瘤大小在肝移植治疗肝细胞癌预后研究中的价值.方法 结合超声、病理以及临床资料,对148例肝细胞癌肝移植患者的生存情况进行回顾性分析.结果 患者移植术后1、2、3、5年累积生存率分别为73.3%、45.6%、35.4%和32.1%;1、2、3、5年无瘤生存率分别为70.7%、44.3%、38.5%和34.5%;随访期间肿瘤复发转移的总发生率为43.2%.单因素分析结果显示,肿瘤总直径(χ2=15.098,P=0.001)是影响肝细胞癌患者肝移植术后累积生存率的因素,肿瘤总直径(χ2=29.038,P<0.001)是影响无瘤生存率的因素.多因素分析结果显示,肿瘤总直径(R2=1.610,P=0.008)是影响累积生存率的独立危险因素,肿瘤总直径(R2=2.206,P<0.001)是与无瘤生存率显著相关的独立危险因素.结论 肿瘤总直径是独立性的预后影响因素,超声检测肿瘤大小有助于患者适应证的选择.

Tumor size assessment with ultrasound as a prognostic factor for patients with liver transplantation for hepatocellular carcinoma

Objective To evaluate the assessment of tumor's size with ultrasound in research of prognosis of liver transplantation for hepatocellular carcinoma (HCC). Methods Clinical data of 148 patients with HCC who underwent liver transplantation were analyzed retrospectively. Results One-, 2-,3-,and 5-year overall actuarial survival were 73.3% ,45.6% ,35.4% ,and 32.1%,respectively. One-,2-,3-,and 5-year overall recurrence-free survival were 70.7 %, 44.3 %, 38. 5%, and 34. 5%, respectively. The overall tumor recurrence rate was 43.2%. Univariate analysis indicates that (the Kaplan-Meier method with the Log-Rank test) the total tumor burden (TTB) (χ2=15.098,P=0.001) was found to be significantly affecting the actuarial survival. While TTB (χ2=29. 038, P<0.001) was for recurrence-free survival. In multivariate analysis (with the multivariate Cox proportional hazards model), TTB (R2=1.610, P =0. 008) was found to be an independent predictor of actuarial survival. On the other hand, TTB (R2 =2. 206, P<0.001) was identified as the prognostic factor independently related to recurrence-free survival. Conclusions TTB is an independent prognostic factor for patients with liver transplantation for HCC. Assessment of tumor size with ultrasound is beneficial to the evaluation of indication for liver transplantation when patients with HCC were concerned.