肝细胞肝癌肝移植的预后因素分析

目的评价肝细胞肝癌（ hepatocellular carcinoma, HCC）原位肝移植后的预后相关因素。方法回顾性分析1993年11月到2006年5月期间汉诺威医科大学对117例HCC进行肝移植的经验。结果经多因素分析，肿瘤大小和肿瘤数量（米兰标准或加州标准）、微血管侵犯、移植前治疗和肿瘤复发是影响患者生存预后的重要因素。结论原位肝移植是治疗HCC的理性术式；合适的选择标准，积极的移植前治疗，复发的有效控制，是患者获得良好预后的关键。

Prognostic factors of liver transplantation for hepatocellular carcinoma

Objective To evaluate the results of liver transplantation （LT） for hepatocellular carcinoma （HCC）, and to identify major factors influencing the patients＇ outcome. Methods One hundred and seventeen cases of LT for HCC were retrospectively analyzed in a single transplantation center, Medical School of Hanover, during the period between November 1993 and May 2036. The cumulative survival rates were calculated using the Kaplan-Meier method and the differences between various groups were analyzed by Log-rank test. Results The tumor size and number are two major factors affecting prognosis of LT for HCC. Analysis of multiple variables on overall survival showed that tumor size and number （Milan criteria and UCSF criteria）, presence of micro-vascular invasion, with or without preoperational treatment and tumor recurrence were statistically significant predictors of survival. Conclusion LT is a rational therapeutic option for patients with HCC. Suitable selection criteria, positive pre-transplantation treatment and recurrence effective control are crucial for obtaining a good prognosis.