肝癌根治性切除术后复发的高危因素分析

High-Risk Factors of Recurrence after Radical Resection of Hepatocellular Carcinoma

目的分析影响肝癌根治性切除术后复发的高危因素,为肝癌治疗及预后提供参考依据。方法选取80例肝癌患者作为研究对象,根据随访期间患者复发情况将患者分为复发组37例和未复发组43例,并采用多因素Logisitic回归分析影响肝癌术后复发的高危因素。结果肝癌患者的复发率为46.25%,单因素分析显示,肝癌患者根治性切除术后复发与肿瘤直径、术前AFP值、HBV-DNA水平、血管侵犯、肿瘤包膜完整、肿瘤包膜浸润有关(P<0.05);多因素Logistic回归分析结果显示,肿瘤直径≥5 cm、HBV-DNA水平>105 copies/ml、有肿瘤包膜浸润是肝癌术后出现复发的独立危险因素。结论肝癌患者经根治性切除术后的复发率较高,其中肿瘤直径≥5 cm、HBV-DNA水平>105 copies/ml、有肿瘤包膜浸润是影响肝癌术后复发的高危因素。

Objective To analyze the high-risk factors influencing recurrence after radical resection of hepatocellular carcinoma(HCC),aiming at providing reference for HCC treatment and prognosis.Methods 80 cases of HCC patients were enrolled as study objects.According to recurrence situations during follow-up period,they were divided into recurrence group(n=37)and non-recurrence group(n=43).The high-risk factors influencing recurrence after HCC surgery were analyzed by Multivariate Logisitic regression analysis.Results The recurrence rate of HCC patients was 46.25%.Univariate analysis showed that recurrence after radical resection for HCC was related with tumor diameter,preoperative AFP value,HBV-DNA level,vascular invasion,integrity and infiltration of tumor capsule(P<0.05).The results of multivariate Logistic regression analysis showed that tumor diameter not shorter than 5cm,HBV-DNA level higher than 105 copies/ml and tumor capsule infiltration were independent risk factors of recurrence after HCC surgery.Conclusion The recurrence rate is high in HCC patients after radical resection.The tumor diameter not shorter than 5cm,HBV-DNA level higher than 105 copies/ml and tumor capsule infiltration are high-risk factors influencing recurrence after HCC surgery.