临床与非临床因素对原发性肝癌预后的影响

Influence of Clinical and Non-clinical Elements on Prognosis of Hepatocellular Carcinoma

目的 探讨原发性肝癌的生存率及影响原发性肝癌预后的因素。方法 1997年 1月～ 1998年 5月住院原发性肝癌 12 3例 ,以Kaplan -meier法计算其生存率 ,并收集可能影响预后的 31个因素的资料 ,运用Cox回归模型进行预后因素分析。结果 全部病例 1、2、3年生存率分别为 4 6 2 2 %、2 6 89%和 16 5 7%。Cox回归模型单因素分析显示自费医疗、病理大体类型为巨块型、HBsAG阳性、淋巴转移、远端转移和临床分期对预后有显著影响 ;多因素分析后 ,HBsAg阳性、淋巴转移、临床分期进入回归模型。结论 除淋巴转移、临床分期等临床因素外 ,非临床因素如HBsAg阳性。

Objective To explore the survival rate and the factors which affect profoundly the prognosis of patients with hepatocellular carcinoma. Methods One hundred and twenty three cases with hepatocellular carcinoma were selected,and analyses of survival rate and 31 prognosis-related factors were performed by using Kaplan-meier method and Cox model. Results The results showed that all survival rate at 1,2,3 year levels was 46.22%, 26.89% and 16.75% respectively. The result of multivariate Cox model analysis showed that the statistically significant prognostic factors were clinical stage, positive HBsAg and lymphatic metastasis. Conclusion Clinical factors, such as clinical stage and lymphatic metastasis and non-clinical factors, such as self-paid for medical fees, positive HBsAg, exerted equally the influence on prognoisis of hepatocellular carcinoma patients.