男性肝细胞癌患者的临床病理特点及影响因素

Clinicopathological Features,Postoperative Survival and Prognostic Influencing Factors of Male Patients with Hepatocellular Carcinoma

目的探讨男性肝细胞癌患者的临床病理特征、术后生存及预后影响因素。方法回顾性分析1995年1月至2002年12月期间我科行肝切除术之155例男性肝细胞癌患者的临床及随访资料,单、多因素分析确定预后影响因素。结果与同期24例女性患者比较,男性肝细胞癌患者年长5.7岁,并有较高的HBsAg阳性率(80.6%vs54.2%)和肝硬变比率(87.1%vs37.5%),P<0.05,其他临床病理指标差异无统计学意义(P>0.05)。多因素分析提示,Edmondson-Steiner分级和门静脉癌栓为男性患者术后总体生存和无瘤生存的独立影响因素,卫星灶和肿瘤大小仅影响总体生存。结论男性肝细胞癌患者主要的临床病理特征及术后生存情况与女性患者相似。肿瘤分化程度和生物学行为是影响男性肝细胞癌患者术后生存的主要因素。

Objective To investigate the clinicopathological features, postoperative survival and prognostic influencing factors of male patients with hepatocellular carcinoma （HCC）. Methods The clinicopathological features and the follow-up data of 155 male HCC patients who received hepatectomy from Jan. 1995 to Dec. 2002 were retrospectively analyzed and the prognostic influencing factors were defined by uni- and multi-variate analysis. Results Compared with 24 female patients at the same period, males were about six-year older and both of their hepatitis B surface antigen （HBsAg） and liver cirrhosis positive rates were higher （P〈0.05）, but there were no significant differences of the other clinicopathological parameters between the male group and the female group. Multivariate analysis showed that Edmondson-Steiner grade and portal vein tumor thrombosis （PVTT） were two independent prognostic influencing factors of both the overall survival and the tumor-free postoperative survival of male patients with HCC, while satellite nodule and tumor size only influenced the overall survival, Conclusion The main clinicopathological features and t.he postoperative survival of male HCC patients were similar than those of female＇s. Tumor differentiation and biological behaviors were major factors affecting postoperative survival of male patients with HCC.