肝癌切除术后复发的危险因素分析

Risk factors for recurrence of primary liver cancer after hepatectomy

目的分析肝癌切除术后复发的危险因素。方法选取87例肝癌行肝切除术患者,观察术后肝癌复发情况;收集患者临床资料,应用Cox回归模型分析肝癌切除术后复发的危险因素。结果 87例患者术后中位随访时间36个月,肝癌复发29例(33.3%)。Cox回归分析显示,术前甲胎蛋白异质体L3≥10%、大结节型肝硬化、肿瘤数目>3个、肿瘤最大直径>5 cm、门静脉和(或)肝静脉癌栓及术后HBV-DNA数量级升高与肝癌术后复发密切相关(P均<0.05)。结论肝癌切除术后复发的危险因素有术前甲胎蛋白异质体L3≥10%、大结节型肝硬化、肿瘤数目>3个、肿瘤最大直径>5 cm、门静脉和(或)肝静脉癌栓及术后HBV-DNA数量级升高。

Objective To analyze the risk factors for the recurrence of primary liver cancer after hepatectomy.Meth-ods A total of 87 cases of patients with hepatocellular carcinoma undergoing hepatectomy were selected and the recurrence was observed.Cox regression analysis was used to analyze the risk factors for postoperative recurrence.Results The medi-an follow-up of 87 patients was 36 months and the recurrence rate was 33.3%（29 cases）.Cox regression analysis revealed that preoperative AFP-L3%≥10%, macronodular cirrhosis, the number of tumor 〉3, the maximal diameter of tumor 〉5 cm,hepatic veins or portal vein tumor thrombus and the elevated levels of HBV-DNA were independent risk factors for postoperative recurrence of hepatocellular carcinoma （all P〈0.05）.Conclusions The independent risk factor for the postoperative recurrence of hepatocellular carcinoma are AFP-L3%≥10%, macronodular cirrhosis, the number of tumor〉3, the maximal diameter of tumor 〉5 cm,hepatic veins or portal vein tumor thrombus and the elevated levels of HBV-DNA.