老年肝癌根治性切除术后肝癌复发的高危因素分析

Analysis of high risk factors for recurrence of hepatocellular carcinoma in elderly patients after radical hepatectomy

目的:探讨老年肝癌根治性切除术后肝癌复发的高危因素。方法:选择我院于2015年1月至2017年1月期间收治的行肝癌根治性切除术的老年肝癌患者300例作为研究对象。所有研究对象均完成术后12个月随访,观察患者复发情况,其中肝癌术后复发时间以影像学检查有明确的肿块存在为确诊依据。运用多因素分析术后复发危险因素。结果:老年肝癌根治性切除术患者300例,术后随访12个月肝癌复发58例,复发率为19.33%。经单因素分析显示,两组性别、合并基础疾病、术前ALT、术前AST和手术时间比较无统计学差异(P>0.05);两组肿瘤直径、血管侵犯、肿瘤包膜和术中失血比较具有统计学差异(P<0.05)。将上述单因素分析具有统计学意义的纳入多因素分析显示,肿瘤直径、血管侵犯、肿瘤包膜和术中失血为影响老年肝癌根治性切除术后复发危险因素。结论:老年肝癌根治性切除术后肝癌复发影响因素较多,而肿瘤直径、血管侵犯、肿瘤包膜和术中失血为其危险因素。

Objective:To investigate the risk factors of recurrence of hepatocellular carcinoma in elderly patients after radical resection of hepatocellular carcinoma.Methods:300 elderly patients with hepatocellular carcinoma who underwent radical hepatectomy in our hospital from January 2015 to January 2017 were selected as the study subjects.All the subjects were followed up for 12 months after operation to observe the recurrence of hepatocellular carcinoma.The time of recurrence of hepatocellular carcinoma after operation was based on the existence of clear masses by imaging examination.Multivariate analysis was used to analyze the risk factors of postoperative recurrence.Results:There were 300 elderly patients who underwent radical resection of hepatocellular carcinoma.After 12 months follow-up,58 patients had recurrence of hepatocellular carcinoma,and the recurrence rate was 19.33%.Univariate analysis showed that there was no significant difference in gender,underlying diseases,preoperative ALT,preoperative AST and operation time between the two groups(P>0.05).There was significant difference in tumor diameter,vascular invasion,tumor capsule and intraoperative blood loss between the two groups(P<0.05).Including the above univariate analysis into multivariate analysis showed that tumor diameter,vascular invasion,tumor capsule and intraoperative blood loss were risk factors for recurrence of elderly patients with hepatocellular carcinoma after radical resection.Conclusion:There are many factors influencing the recurrence of hepatocellular carcinoma in the elderly after radical resection of hepatocellular carcinoma.Tumor diameter,vascular invasion,tumor capsule and intraoperative blood loss are the risk factors.