肝细胞癌术后肝外转移的相关临床病理学因素分析

Clinicopathological features associated with extrohepatic metastasis of postoperative hepatocellular carcinoma

目的探讨肝细胞癌(HCC)术后肝外转移相关的临床病理学参数。方法纳入HCC根治术患者66例,随访术后肝外转移情况,中位随访时间31.7个月。临床病理学参数与肝外转移的相关性分析采用Logrank检验、Kaplan-Meier曲线和多变量Cox风险比例模型。结果单因素分析结果显示,合并高血压、无完整肿瘤包膜和肿瘤分期III期与HCC术后肝外转移风险呈正相关(均P<0.05),而低血小板计数和血浆凝血酶原时间延长与肝外转移风险呈负相关(均P<0.05)。进一步多因素Cox回归分析显示,合并高血压和肿瘤III期与HCC术后肝外转移显著相关(均P<0.05)。结论合并高血压以及高肿瘤分期是HCC术后肝外转移的独立风险因素。

Objective To investigate the clinicopathological parameters associated with extrohepatic metastasis of postoperative hepatocellular carcinoma（HCC）. Methods A total of 66 HCC patients who underwent radical surgery were enrolled in the present study. Follow-up data were available for all patients, and median follow-up time for metastasis was 31.7 months. The association between clinicopathological parameters and extrohepatic metastasis was analyzed by Log-rank test, Kaplan-Meier survival analysis and Cox proportional hazards models. Results Univariate analysis showed that hypertension, absence of complete tumoral capsule, and TNM III stage were associated with increased risk for extrohepatic metastasis （allP 〈 0.05）, while lower platelet counts and prolonged plasma prothrombin time were associated with decreased metastasis risk （both P 〈 0.05）. Multivariate analyses revealed that hypertension and TNM III stage were significantly associated with increased risk for extrohepatic metastasis （bothP 〈 0.05）. Conclusions Hypertension and advanced tumor stage were independent risk factors for extrohepatic metastasis of postoperative HCC.