肝细胞肝癌患者术后早期复发情况

目的观察肝细胞肝癌(HCC)患者术后准确的复发时间,进一步探讨影响肝癌术后复发的危险因素。方法将我院肝脏外科收治的肝癌肝切除术患者94例根据数字减影血管成像技术(DSA)确诊的术后复发时间分为1~6月复发组、7~12月复发组和1年内无复发组;肝内复发病例予栓塞治疗,并应用栓塞后CT、造影超声、磁共振成像等检查手段予以验证。结果半年复发率为30.9%,1年复发率为36.2%,半年和1年复发率比较差异无显著性。复发组有多发性肿瘤病例9例(26.5%),无复发组5例(8.3%),两组比较差异具有显著性(P=0.032)。通过其他检查手段验证DSA的诊断准确性为87.2%。结论HCC术后复发的高峰时间在术后半年内,肿瘤多发性是导致进展期肝癌术后早期复发的重要因素。DSA是早期发现HCC术后肝内复发的重要手段,同时还可以给予早期治疗、控制复发肿瘤进展并为以后的积极治疗创造条件。

Early recurrence after the resection of hepatocellular carcinoma

Objective To observe the precise time of the recurrence after resection of hepatocellular carcinoma(HCC) and to further explore the risk factors associated with postoperative recurrence.Methods Totally 94 patients who had undergone resection of HCC were divided into three groups based on the time of recurrence,which was indicated by the digital subtraction angiography(DSA) examination: recurrence between 1 to 6 months,recurrence between 7 to 12 months,and tumor-free after 12 months.Patients with intra-hepatic recurrence were treated with transcatheter arterial chemoembolization and confirmed by CT scans after embolization,contrast-enhanced ultrasound,or magnetic resonance imaging.Results The recurrence rates of 6 months and 1 year were 30.9% and 36.2%,respectively.No statistically significant difference between 6-month and 1-year recurrence rates was observed.Nine(26.5%) patients with recurrence and five(8.3%) patients free of tumor had previously presented as multifocal HCC,which showed a statistical significance(P=0.032).The diagnostic accuracy of DSA was 87.2%,which was eventually confirmed by the other investigations.Conclusions Most recurrences occure within the first six months postoperatively and multifocal carcinogenesis is one of the risk factors associated with early recurrence after liver resection for advanced HCC.DSA is an important surveillance for early detection of intra-hepatic recurrence after surgery;meanwhile,it also provides information for early management to control the disease progression and for future active therapies.