| 微血管侵犯对肝细胞癌肝移植术后预后的影响 |
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| 引用本文： | 刘建勇,杨芳,蔡秋程,翁亮,黄兴华,江艺. 微血管侵犯对肝细胞癌肝移植术后预后的影响[J]. 蚌埠医学院学报, 2018, 43(10): 1364-1367. DOI: 10.13898/j.cnki.issn.1000-2200.2018.10.022 |
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| 作者姓名： | 刘建勇 杨芳 蔡秋程 翁亮 黄兴华 江艺 |
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| 作者单位： | 南京军区福州总医院 肝胆外科, 福建 福州 350025 |
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| 基金项目： | 福建省自然科学基金面上项目（2016J01585） |
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| 摘 要： | 目的:探讨微血管侵犯（microvascular invasion，MVI）对肝细胞癌（HCC）肝移植术后预后的影响。方法:回顾性分析HCC行原位肝移植手术病人183例的临床和随访资料，其中符合米兰标准76例，USCF标准84例，上海标准102例，杭州标准126例。用Kaplan-Meier法计算4组1年、3年、5年累积生存率，并用Log-Rank检验比较各组生存曲线的差异。将每组分为MVI和无MVI亚组，比较肿瘤复发率、5年无瘤生存率及1年、3年、5年生存率。结果:4组病人的生存时间差异均无统计学意义（P>0.05）；随着HCC肝移植标准扩大，MVI率逐渐升高（P<0.05），3年、5年生存率和5年无瘤生存率均逐渐降低（P<0.05）。符合上海标准病人中，无MVI亚组肿瘤复发率低于MVI亚组（P<0.05），5年生存率和5年无瘤生存率均高于MVI亚组（P<0.05）；符合杭州标准病人中，无MVI亚组肿瘤复发率低于MVI亚组（P<0.05），3年、5年生存率和5年无瘤生存率均高于MVI亚组（P<0.05~P<0.01）。结论:MVI可预测符合上海标准和杭州标准的HCC肝移植术后复发情况，对肝移植综合治疗具有指导意义。
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| 关 键 词： | 肝肿瘤 微血管侵犯 肝移植 生存率 |
| 收稿时间： | 2018-06-20 |
Effect of the microvascular invasion on the prognosis of hepatocellular carcinoma after liver transplantation |
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| Affiliation: | Department of Hepatobiliary Surgery, Fuzhou General Hospital, Fuzhou Fujian 350025, China |
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| Abstract: | Objective:To investigate the effects of microvascular invasion(MVI) on the prognosis of hepatocellular carcinoma (HCC) after liver transplantation.Methods:The clinical data of 183 HCC patients treated with orthotopic liver transplantation were retrospectively analyzed.Seventy-six cases according with the Milan standard,84 cases according with USCF standard,102 cases according with Shanghai standard and 126 cases according with Hangzhou standard were identified.The 1-year,3-year and 5-year cumulative survival rates in four groups were calculated using Kaplan-Meier method,and the differences of survival curves among the four groups were compared using Log-Rank test.Each group was subdivided into the MVI group and non-MVI group,and the recurrence rate of tumor,5-year disease-free survival rate,and 1-year,3-year,5-year survival rates were compared between two groups.Results:There was no statistical significance in survival time among four groups(P>0.05).With the expansion of liver transplantation standard,the MVI rate gradually increased,the 3-year,5-year survival rates and 5-year disease-free survival rate gradually decreased(P<0.05).Among the patients according with Shanghai standard,the tumor recurrence rate in non-MVI group was lower than that in MVI group(P<0.05),and the 5-year survival rate and 5-year disease-free survival rate in non-MVI group were higher than that in non-MVI group(P<0.05).Among the patients according with Hangzhou standard,the tumor recurrence rate in non-MVI group was lower than that in MVI group(P<0.05),and the 5-year survival rate and 5-year disease-free survival rate in MVI group were higher than that in MVI group(P<0.05 to P<0.01).Conclusions:Microvascular invasion can predict the recurrence of HCC after liver transplantation,which has guiding significance in comprehensive treatment of liver transplantation. |
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