影响肝癌根治性切除后复发率的因素

Clinico pathological factors influencing the disease-free survival of patients with hepatocellular carcinoma after radical operation

目的 原发性肝癌根治性切除后的 5年生存率达到 4 0 % -50 % ,而切除后 5年复发率为 60 %左右 ,本研究为鉴别高复发倾向人群对复发的防治提供依据。方法 78例病理证实的原发性肝癌病人接受根治性切除手术 ,随访 5年以上 ,回顾性分析病人的临床病理资料 ,经统计学处理分析各种临床病理因素对复发率的影响。结果 肿瘤大小是唯一影响全体肝癌病人无瘤生存率的因素 ,在小肝癌病人中 ,肿瘤血管密度是影响病人无瘤生存率的因素。结论 肿瘤大小仍是决定病人术后复发率最重要的因素 ,肿瘤血管密度对小肝癌病人的预后有预测作用。

Objective To explore the factors influencing the prognosis of patients with hepatocellular carcinoma after radical operation. Methods Seventy eight patients with pathologically proved and radically operated hepatocellular carcinoma were recorded, and followed up at least 5 years. The clinico pathological data were collected including the microvessel density using immunohistochemistry by anti-CD34 antibody. Statistical analysis was done to evaluate the influence of these factors.Results The 5 year disease-free survival (DFS) rate was 42 8% in this series, while it was 53 4% in the patients with small liver cancer(≤5 cm). Both univariate and multivariate analyses indicated the tumor size were the only factor influencing DFS, the possibility of recurrence for the patients with big tumor(>5cm) was 1.9 fold higher than with small tumor; however, in small liver cancer patients, microvessel density was the only factor influencing the DFS: the possibility for recurrence for the patients with hypervascular tumors was 3.12 fold higher than that with hypovascular tumors. Conclusions Tumor size was the only factor influencing DFS; however, in small liver cancer patients, microvessel density was the factor influencing DFS.