107例肝细胞肝癌切除术后预后因素分析

目的 探讨影响肝细胞肝癌切除术后的预后因素。方法 回顾性分析广西医科大学肿瘤医院2002年6月~2004年5月间107例肝细胞肝癌手术切除患者的临床资料，选择38项临床病理因素分析其对生存率的影响。Kaplain-Meier法计算生存率，单因素分析采用Log-rank检验，多因素分析采用Cox模型筛选出对肝细胞肝癌切除预后有影响的临床病理因素。结果 全组1、3、5年生存率为85.0%，53.3%，43.9%。单因素分析：术前GGT，术前肝功能Child-Pugh分级，术后ALB，术后TBIL，术后ALP，术后GGT，肿瘤最大直径，门静脉癌栓，术中失血情况，围手术期输血，术后是否复发以及手术是否根治切除等。多因素分析：术后ALB，术后ALP，门静脉癌栓，术后是否复发，手术是否根治切除与预后相关。结论 术后ALB，术后ALP，门静脉癌栓，术后复发，根治性切除是影响肝细胞肝癌术后生存期的独立预后因素。

Analysis of prognostic factors in 107 cases with hepatocellular carcinoma after hepatectomy

Objective To explore the prognostic factors of hepatocellular carcinoma(HCC) patients after hepatectomy.Methods A data of patients underwent surgical resection of hepatocellular carcinoma in Affliliated Tumor Hospital of Guangxi Medical University from June 2002 to May 2004 were retrospectively analyzed.A total of 107 patients were enrolled for reviewing their clinical characteristics treatment and prognosis.38 parameters contributing to survival rate(SR) were analyzed.Kaplain-Meier method was used to evaluate survival rates.Log-rank test was used to univarivate analysis.Cox’s regression of multivariate analysis was done in order to determine clinicopathologic factors which had influence hepatectomy HCC patients after hepatectomy.Results The 1-year,3-year and 5-year cumulative SR of the whole group were 85.0%,53.3%,43.9%,respectively.The results of univariate annlysis showed fators : preoperative blood-serum GGT,preoperative hepatic functional Child-Pugh classification,post-operative blood-serum ALB,post-operative blood-serum TBIL,post-operative bloodserum ALP and post-operative blood-serum GGT,maximum tumor diameter,portal vein tumor thrombus,intraoperative blood loss,perioperative blood transfusion,recurrence and radical resection.Multivariative analysis showed post-operative blood-serum ALB,post-operative blood-serum ALP,portal vein tumor thrombus,recurrence and radical resection were associated with prognosis.Conclusion Hepatic functional classification,hepatic cirrhosis,tumor diameter,portal thrombi,TNM classification,radical resection are important risk factors for prognosis on HCC patients after hepatectomy.