透明细胞型肝癌患者术后复发和生存状况研究

目的：探究原发性透明细胞型肝细胞肝癌（PCCCL）患者术后复发和生存状况。方法选取2010年1月—2013年1月期间该院接收治疗的原发性透明细胞型肝癌患者226例，分析患者的临床资料和术后随访资料。根据治疗方法将226例患者分为两组，对照组有113例患者，采用根治性手术治疗。观察组有113例患者，采用根治性手术＋术后化疗进行治疗。患者在术后1年或者1年内复发为早期复发，在术后1年以上复发为晚期复发。分析两组患者的术后复发率和生存率，探究影响透明细胞型肝癌术后复发的相关因素。结果226例患者中有45例术后复发，其中早期复发患者15例，晚期复发患者30例。观察组患者在术后1、2、3年内的总生存较对照组无明显差异（P＞0．05）。观察组患者在术后1、2、3年内的总复发率较对照组患者无明显差异，比较两组差异不具有统计学意义（P＞0．05）。多因素分析两组患者术后复发因素，讨论得出年龄是PC-CCL患者术后晚期复发惟一的独立危险因素。血管侵犯、肿瘤＞5 cm、血清谷丙转氨酶（ALT）＞40 U·L－1和丙氨酯转氨酶水平是PCCCL患者术后早期复发的独立危险因素。结论明确PCCCL患者晚期复发和早期复发的各种危险因素，可以及时发现患者的术后复发，提高患者术后生存率。

Research recurrence and survival in patients with clear cell type of liver cancer after surgery

Objective To investigate the recurrence and survival conditions of patients with the primary clear cell hepatocellular carci-noma (primary clear cell carcinoma of the liver,PCCCL)after surgery.Methods 226 cases who received treatment for primary clear cell liver cancer from January 2010 to January 2013 in our hospital were selected,and clinical and postoperative follow-up data were an-alyzed.226 cases were divided into two groups:1 13 patients in the control group,who were treated with radical surgery;the other 1 13 patients in the observation group,who were treated with radical surgery plus postoperative chemotherapy treatment.Recurrence within one year after surgery is early relapse,while more than a year is late recurrence.Recurrence and survival rates were thus analyzed in these two groups to explore relevant factors which cause the recurrence of clear cell type of liver cancer.Results The recurrent cases in all 226 cases is 45,including 15 cases of early relapse and 30 cases of late relapse.Overall survival rates after 1,2,3 years were not significantly different between two groups (P >0.05),which is the same case with the overall recurrence rates after 1,2,3 years (P>0.05).Multivariate analysis showed that age is the only independent risk factor for recurrence in patients with advanced PCCCL. Vascular invasion,tumor size (>5cm),serum ALT (>40 U·L-1 )and propylene urethane aminotransferase levels were independ-ent risk factors for recurrence in patients with early postoperative PCCCL.Conclusions Knowing a variety of risk factors for early re-currence in PCCCL patients will improve early diagnosis of recurrence and survival rates.