男性肝细胞肝癌术后预后因素分析

Prognostic Factors for Male Patients with Hepatocellular Carcinoma after Hepatectomy

目的:探讨男性肝细胞肝癌术后的预后影响因素。方法:利用COX回归回顾性分析2000年1月至2005年12月天津医科大学附属肿瘤医院经病理证实的接受肝细胞肝癌根治术治疗的426例男性肝细胞肝癌患者的临床病理学资料和预后特点,并与同期接受肝细胞肝癌根治术的71例女性肝细胞肝癌患者的临床病理学资料和预后特点进行比较。结果:男性肝细胞肝癌患者的1年生存率和3年生存率分别为54.9%(234/426例)和31.0%(132/426例),女性肝细胞肝癌患者的1年生存率和3年生存率分别为56.3%(40/71例)和40.8%(29/71例),女性肝细胞肝癌患者的预后好于男性,但男、女性肝细胞肝癌患者的总生存率相比无统计学差异(P>0.05)。单因素分析显示:饮酒、GGT、AFP、肿瘤大小、数目、门脉瘤栓(PVTT)、TNM分期和Edmondson分级为男性肝细胞肝癌患者预后的影响因素(P<0.05);AFP、Edmondson分级为女性肝细胞肝癌患者预后的影响因素(P<0.05)。COX回归多因素分析显示:饮酒、AFP、肿瘤大小、门脉瘤栓和Edmondson分级为男性肝细胞肝癌患者预后的独立影响因素(P<0.05),Edmondson分级为影响女性肝细胞肝癌患者预后的独立因素(P<0.05)。结论:饮酒、AFP、肿瘤大小、门脉瘤栓和Edmondson分级等因素对男性肝细胞肝癌患者有预后价值,Edmondson分级为影响女性肝细胞肝癌患者预后的独立因素。

Objective： To identify prognostie faeturs for male patients with hepatocellular careinoma （HCC） after hepatectomy. Methods： Data from 426 male patients who underwent hepatectomy liar pathology-proven HCC in our hospital between January 2000 and December 2005 were retrospectively reviewed. Their elinieal, pathological, and laboratory data were analyzed ahmg with prognosis and were compared with those of 71 female HCC patienis who underwent, hepatectomy at the same time. Results： 1- and 3-year overall survival rates were 55% and 56% in the male patients, and 31% and 41% in the female patients （P〉0.05）. In univariate analysis, tile prognosis of male HCC patients way associated wilh aleohol abuse, γ-glutamyhransferase（GGT） level, alpha fetoprotein（AFP） level, tumor size, number of tumors, portal vein tumor thrombosis （PVTT）, TNM staging and Edmondson＇s elassifieation. AFP expression and Edlondson＇s elassifieation were prognostic faetors for female HCC patients. In muhivariate analysis, alcohol abuse, AFP expression, tumor size. PVTT and Edmondson＇s classification were identified as independent survival predictors for male HCC patients. In female HCC patients, multivariate analysis showed thai Edmondson＇s classification was the sole independent predictor of survivah Conclusion： Alchol abuse, AFP expression, tremor size, PVTT and Edmondson＇s classification are prognostic factors for male HCC patients, Edmondson＇s elassifieation is an independent survival predietor for female HCC patients.