肝细胞癌切除术后不同生存期相关危险因素分析

Risk factors for different survival time after resection of hepatocellular carcinoma

目的探讨肝细胞癌切除术后早期和后期死亡的不同危险因素,为临床干预提供依据。方法回顾性分析1996年1月-2003年12月我院肝胆外科174例手术切除肝细胞癌病例的临床和病理资料,将其分为早亡组(术后生存时间≤2年,n=61),后亡组(2年<术后生存时间≤5年,n=29)和5年生存组(术后生存时间>5年,n=84),比较相关资料,并结合随访结果进行危险因素及预后分析。结果多因素分析显示大血管侵犯、肿瘤低分化、大直径肿瘤和男性为早期死亡危险因素;而血清高GGT值为后期死亡的危险因素。结论早期死亡和肿瘤因素密切相关,应加强术后继续治疗;后期死亡则与病肝状态相关,血清GGT可能有预测价值。

Objective To study the different risk factors for early and late death of patients after resection of hepatocellular carcinoma （HCC） in order to provide evidence for its clinical intervention. Methods Clinical and pathological data about 174 patients who underwent resection of HCC at our department in January 1996-December 2003 were retrospectively analyzed. The patients were divided into early death group（n=61, postoperative survival time≤2 years）, late death group（n=29, postoperative survival time 2 years≤5 years）, 5-year survival group（n=84, postoperative survival time≥5 years）. Risk factors and prognosis were compared and analyzed. Results Multifactor analysis showed that large blood vessels were invaded and HCC was poorly differentiated, and that HCC with a large diameter and males were the risk factor for early death while high serum GGT level was the risk factor for late death of HCC patients. Conclusion Early death of HCC patients is closely related with the risk factors for HCC and the patients should be treated after operation. Late death of HCC patients is related with the condition of liver disease, and serum GGT level may be a predictor for late death of HCC patients.