肝癌根治术后早期肝内复发危险因素分析

A Multivariate Analysis on Risk Factors of Early Intrahepatic Recurrence Following Radical Resection of Primary Hepatic Carcinoma

[目的]探讨原发性肝癌(以下简称肝癌)根治性切除术后早期复发的影响因素。[方法]回顾性分析105例肝癌根治性切除术的病例,研究肿瘤、宿主、治疗等因素与术后早期肝内复发关系。[结果]105例病例中早期肝内复发47例。多因素分析表明肿瘤大小、门静脉分支受侵、术前AFP≥100ng/L是早期复发的独立危险因素。复发高危组2年复发率为56.70%,1、3、5年生存率分别为83.58%、62.65%、21.48%;复发低危组2年复发率为23.70%,1、3、5年生存率分别为86.38%、69.94%、47.85%。二组差异有显著性(P<0.05)。[结论]肿瘤大小、门静脉分支受侵、术前AFP≥100ng/ml是影响病人术后早期肝内复发的重要因素。

To investigate the factors influencing early intrahepatic recurrence after radical resection of primary hepatic carcinoma(PHC).The data of 105 radical resection of PHC were retrospectively reviewed.Clinicopathologic variables including tumor,host and treatment were multivariate analysed.The factors affecting early intrahepatic reccurence were investigated.Early intrahepatic recurrence occurred in 47 of 105 cases.Multivariate analysis showed that tumor size, presence of microvascular invasion, and preoperative serum alpha-fetoprotein (AFP) level≥100ng/ml were independent risk factors of early intrahepatic recurrence.On the basis of this analysis, patients were stratified into high and low risk group of early recurrence.The 2-year recurrence rate was 56.70%.The 1-,3-,and 5-year survival rate were 83.58%, 62.65%, and 21.48% respectively in high risk group;While the 2-year recurrence rate was 23.70%,the 1-,3-,and 5-year survival rate were 86.38%, 69.94%,and 47.85% respectively in low risk group.[Conclusion]Tumor size,microvascular invasion,and preoperative serum AFP level≥100ng/ml are corralated significantly with early intrahepatic recurrence.