原发性肝癌切除后复发时间相关因素的回顾性分析

The retrospective analysis of the relative factors that affected the post-operative recurrent time of the primary hepatocellular carcinoma patients

目的探讨影响原发性肝细胞癌手术切除后复发时间的临床病理因素。方法收集107例手术切除的原发性肝癌患者的临床病理资料，采用单因素和多因素方法分析可能影响术后复发时间的因素。结果单因素分析显示，手术切缘距肿瘤边缘是否〉1cm、肿瘤的分化程度、肿瘤结节数目、合并肝硬化、甲胎蛋白（AFP）水平及门静脉癌栓是影响肝癌切除后复发时间的重要因素（P〈0．01）；多因素分析显示，病理分级、肿瘤大小、数目、肝功能分级、是否存在门静脉癌栓及是否采用门静脉免疫化疗是影响肝癌手术切除后复发时间的独立危险因素（P〈0．05）。结论肿瘤病理分级、肿瘤大小、数目、肝功能分级、是否存在门静脉癌栓及是否采用门静脉免疫化疗等因素是影响肝癌手术切除后复发时间的独立危险因素，临床治疗过程中需根据具体情况综合判断。

Objective To explore the clinical and pathological factors that affected the post-operative recurrent time of the primary hepatocellular carcinoma. Methods The clinical and pathological factors of 107 primary hepatocellular carcinoma patients received hepatectomy were collected, and the factors affected post-operative recurrent time were analyzed with univariate and multivariate statistical methods. Results The pathological type, operation margin, tumor size, tumor number, fetoprotein （AFP） level, cirrchosis,and portal vein tumor thrombus were all the factors that affected the post-operative recurrent time with the univariate statistical analysis （ P 〈 0.01 ）. The pathological type, operation margin, tumor size, tumor number, the liver function, portal vein tumor thrombus, and portal vein immunochemotherapy were the in- dependent prognosis factors that affected post-operative recurrent time by multivariate Cox regression （ P 〈 0.05 ）. Conclusions The pathological type, operation margin, tumor size, tumor number, portal vein tumor thrombus, and portal vein immunochemotherapy affected the post-operative recurrent time of the primary hepatocellular carcinoma patients. A comprehensive decision strategy should be carried out by clinicians according to the specific situations.