肝癌手术切除术后复发相关因素分析

Factors influencing postoperative recurrence in patients with primary liver cancer after hepatectomy

目的研究影响肝癌患者手术后复发的相关因素,为临床预测患者术后复发提供指导。方法回顾性分析我院2012年6月~2014年6月期间163例接受肝癌手术切除术患者的临床资料,随访并计算2年肿瘤复发和生存情况。收集所有患者的临床和病理学资料,应用SPSS 19.0统计学软件对相关资料进行处理,采用多因素Logistic回归分析影响肝癌患者术后复发的相关因素。结果在随访的2年中,肿瘤复发51例,未复发112例;复发患者术前存在肝硬化(80.39%)、肿瘤包膜不完整率(96.08%)、肝癌细胞分化为III和IV级比例(15.69%)、多发性肿瘤(49.02%)、多结节融合型的比例(64.71%)均明显高于未复发患者(P<0.01);多因素Logistic回归分析显示,存在肝硬化、肿瘤包膜不完整、肿瘤细胞分化程度低、肿瘤数目多和肿瘤直径大均是导致肝癌患者术后复发的独立危险因素(P<0.05)。结论肝癌患者术后复发是多种因素造成的,可能与肿瘤大小、有无肝硬化、包膜是否完整、肝癌细胞分化程度和肝癌数目等因素有关,可用于评估患者复发的危险性,对临床早期诊断及治疗具有重要的参考价值。

Objective To investigate the factors influencing postoperative recurrence in patients with primary liver cancer （PLC） after hepatectomy. Methods 163 patients with PLC were recruited in our hospital between June 2012 and June 2014, and they had hepatectomy and followed-up for two years. The clinical materials were retrospectively analyzed and the factors related to the recurrence of cancer after operation were evaluated by using multivariate Logistic regression analysis. Results Out of 163 patients with PLC,51 had,and 112 had not recurrence of tumor in two year follow-up period;the recurrent patients had higher percentage of underlying liver cirrhosis（ 80.39% ） , incomplete envelope of tumor （96.08%）, differentiated grade III and IV tumor cells （15.69%）, multiple foci tumors（49.02%） and multiple-node fusion tumors （64.71%） than in non-recurrent patients （P〈0.01）; multivariate Logistic regression analysis showed that liver cirrhosis, incomplete envelope, degree of differentiation, multiple foci and huge mass were independent risk factors for tumor recurrence after hepatectomy （P〈0.05）. Conclusion HCC recurrence after resection is caused by many factors,including tumor size,liver cirrhosis, capsule integrity,differentiation degree of hepatocellular carcinoma,and multiple tumors,which might hint the risk of recurrence in patients with PLC after hepatectomy.