原发性肝癌肾上腺转移56例的诊治分析

目的总结肝癌。肾上腺转移的临床特点，探讨影响其生存率的临床因素。方法回顾性分析2000年11月至2003年4月期间在我院住院治疗并获得随访的56例发生。肾上腺转移的原发性肝癌病人的临床资料，对是否进行治疗，肾上腺肿瘤大小，是否合并肝内病灶，发病时间，肝功能分级等因素进行单因素及Cox模型多因素分析。结果单因素分析显示。肾上腺肿瘤的大小，有无肝内病灶，是否进行治疗以及肝功能分级是影响病人生存时间的因素，而多因素分析表明是否进行治疗，肝功能分级是影响病人生存率的独立因素。结论对于肝癌肾上腺转移应当保持警惕性，以获得早期诊断，对于部分经过选择的病人以手术为主的综合治疗具有积极的意义。

Diagnosis and treatment of adrenal metastasis of hepatocellular carcinoma

Objective To investigate the clinical features of adrenal metastasis of hepatocellular carcinoma (HCC) and analyze the factors that can influence the survival rate. Methods The clinical data of 56 patients with adrenal metastasis of HCC treated in our hospital from 2000 to 2003 were retrospectively analyzed. All the 56 patients had been successfully followed up. The clinical factors including treatment , tumor size, intrahepatic lesions, relapse time and Child-Pugh score were analyzed with Log-rank and Cox regression tests. Results Kaplan-Meier test revealed that treatment, tumor size, intrahepatic lesions and Child-Pugh score could affect the survival, while multivariate Cox regression test indicated that treatment and Child-Pugh score were independent factors affecting the survival. Conclusions The adrenal metastasis of HCC should be closely monitored to get an early diagnosis. Comprehensive therapy can achieve better outcome in some selected cases.