小肝癌术后早期复发转移临床危险因素分析

目的探讨原发性小肝癌术后早期复发转移的危险因素,为预测和预防小肝癌术后早期复发转移提供理论依据。方法回顾性分析2008-2011年行根治性切除的单发且直径≤5cm的小肝癌患者中术后早期复发转移和晚期复发转移的临床病理特征,用单因素和多因素分析小肝癌早期复发转移的危险因素。结果单因素分析显示小肝癌术后早期复发组和晚期复发组间肿瘤有无包膜(P=0.027)、术后TBIL峰值(P=0.034)、镜下脉管癌栓(P=0.036)有显著性差异;多因素分析提示肿瘤有无包膜是小肝癌术后早期复发的独立危险因素。结论小肝癌复发时间可能与肿瘤有无包膜,术后TBIL峰值和镜下脉管癌栓等因素有关,而肿瘤有无包膜是小肝癌术后早期复发的独立危险因素,需加强此类患的者术后监测,并提前进行干预。

Analysis of Clinical Risk Factors for Early Recurrence and Metastasis of Small Hepatocelluar Carcinoma after Curative Hepatic Resection

Objective To investigate the risk factors for early recurrence and metastasis of small hepatocellular carcinoma after curative hepatic resection,and to provide a theoretical basis for the prediction and prevention of early recurrence and metastasis of small hepatocellular carcinoma.Methods The hepatocelluar carcinoma patients whose lesion was single and lesion diameter was less than 5cm were investigated retrospectively after curative hepatic resection between 2008 and 2011.Univariate and multivariate logistic regression analysis were performed according to the relevant clinical and pathology factors of early and late recurrence patients to analysis of risk factors for early recurrence and metastasis in small hepatocellular carcinoma.Results By univariate analysis,between the early recurrence of small hepatocellular carcinoma group and the late recurrence group,the rest of the clinical cases factors were no statistical significance,in addition to the patient’s tumor capsule(P =0.027),the postoperative peak value of total bilirubin(TBIL)(P =0.034),microvascular invasion by the microscope examination(P =0.036) were significantly different;The multivariate analysis suggest that the tumor capsule is an independent risk factor of early recurrence and metastasis of small hepatocellular carcinoma.Conclusions The patient’s tumor capsulethe postoperative peak value of total bilirubin(TBIL),microvascular invasion by the microscope examination may be closely related with early recurrence and metastasis of small hepatocellular carcinoma.The tumor capsule is an important factor of early recurrence,therefore,to monitor small hepatocellular carcinoma patients without tumor capsule strongly,if necessary,these patients could take the transcatheter care.