肝癌临床病理因素与肝移植术后肿瘤复发的关系

目的探讨原发性肝细胞型肝癌患者行原位肝移植后肝癌复发或转移的影响因素。方法回顾性分析31例肝细胞型肝癌患者肝移植的临床资料,探讨临床病理因素与术后肿瘤复发或转移及无瘤存活率的关系。结果31例患者术后随访时间为12~24个月,中位随访时间为15个月,6个月、12个月及18个月的无瘤存活率分别为83.87%、74.19%及59.49%。Child-Pugh分级、肿瘤的数目、病理Edmondson分级对肿瘤的复发或转移无影响;肿瘤的大小、TNM分期、有无脉管浸润、是否符合Milan标准对肿瘤的复发或转移有显著影响;肿瘤有无脉管浸润以及TNM分期对患者的无瘤存活率有显著影响。结论肿瘤的大小、TNM分期、有无脉管浸润、是否符合Milan标准均能反映肿瘤复发的风险,而肿瘤的TNM分期及肿瘤有无脉管浸润能进一步影响患者术后的无瘤存活率。

Relationship between clinicopathologic features and tumor recurrence in HCC after liver transplantation

Objective To determine the risk factors affecting tumor recurrence and tumor free survival of hepatocellular carcinoma (HCC) following orthotopic liver transplantation (OLT).Methods Thirty-one consecutive patients with HCC receiving OLT were retrospectively reviewed. Clinical and laboratory data including tumor size, number, distribution, vascular invasion, tumor recurrence and survival were analyzed.Results The follow-up duration was 12 to 24 months (mean 15 months). By life table, tumor free survival of 6, 12 and 18 months were respectively 83.87 %, 74.19 % and 59.49 %. The median survival time was 24.00 . Child-Pugh grade, Edmondson grade and tumor number were not closely related with tumor recurrence. Following variables were correlated significantly with tumor recurrence: tumor size, vascular invasion, pTNM, Milan-criteria. Vascular invasion and pTNM were risk factors for tumor free survival.Conclusion Tumor size, pTNM, vascular invasion and MILAN-criteria were risk factors of tumor recurrence, and so that affecting the tumor free survival.