根治性切除肝细胞癌预后影响因素分析

ANALYSIS OF PROGNOSITIC FACTORS IN HEPATOCELLAR CARCINOMA TREATED BY RADICAL RESECTION

目的 探讨肝细胞癌患者经根治性切除后的主要预后影响因素。方法 对 5 6例经根治性切除的患者进行回顾性统计 ,应用 Cox比例风险模型对可能影响预后的 16项指标进行了多因素分析 ,并建立生存预测方程。结果 总生存率 1,3,5年分别为89.73% ,5 4.0 8% ,2 9.12 % ,中位生存期 78.2 4月。影响肝癌预后最明显的因素是门脉癌栓、C- myc表达及肿瘤包膜。生存预测方程总χ2 =5 3.2 81,P<0 .0 0 1。按预后指数分组 ,低危组、中危组及高危组间 5年生存率具显著差异 ,P<0 .0 5。结论 肝细胞癌预后由多种因素决定 ,对于低危组及中危组患者 ,仍应积极手术治疗以期获得较好疗效。

Objective To evaluatte the major prognostic factors in patients with hepatocellar carcinoma(HCC) who were treated by radical resection.Methods 56 cases of HCC treated by radical resection were analyed retrospectoively and statisically.A multivaritate Cox model was used to analyse sixteen factors that might influence the prognosis,and the survival prediction equation.Results The overall cumulative survival rates for 1,3 and 5 years were 89.73%,54.08% and 29.12% respectively.The median duration of survival were 78.24 months.The most significant prognostic factors were tumor thrombus in the portal vein,C-mycexpression and tumor without capsule.The survival prediction equation was X 2=53.281 P<0.001.The index partitioned the patients into low risk group,intermediate group,and high risk group.Five-year survival rates in three groups were sighificant different(P<0.05).Conclution The prognosis of HCC were decided by varied factors.The Surgical treatment shoud be done actively to the patients with low risk and intermediate group in order to improve the prognosis.