单发大肝癌术后早期复发危险因素分析

Risk factors for early recurrence of patients with single large hepatocellular carcinoma after hepatectomy

目的探讨单发大肝癌(肿瘤直径≥5 cm)早期复发危险因素。方法回顾性分析2015年1月至2020年9月间于宁波大学附属李惠利医院接受根治性切除的135例单发大肝癌患者的临床资料。结果 135例患者复发75例,其中早期复发42例。多因素分析显示,甲胎蛋白≥400 ng/ml(OR=3.510,95%CI:1.528~8.064;P=0.003)和微血管侵犯(microvascular invasion,MVI)阳性(OR=2.769,95%CI:1.143~6.706;P=0.024)是单发大肝癌早期复发的独立危险因素。生存分析显示,存在早期复发危险者无复发生存率(甲胎蛋白≥400 ng/ml,χ^(2)=23.038,P<0.001;MVI阳性,χ^(2)=10.554,P=0.001)和总生存率(甲胎蛋白≥400 ng/ml,χ^(2)=14.336,P<0.001;MVI阳性,χ^(2)=10.481,P=0.001)均下降。结论甲胎蛋白≥400 ng/ml和MVI阳性是单发大肝癌早期复发的独立危险因素。

Objective To investigate the risk factors for postoperative early recurrence of patients with single large hepatocellular carcinoma(HCC)(tumor diameter≥5cm).Methods Clinical data of 135 single large HCC patients who underwent radical resection from Jan 2015 to Sep 2020 in Ningbo Medical Centre Lihuili Hospital were analyzed.Results Seventy-five HCC patients suffered recurrence,among those 42 patients had early recurrence(within 12 months).Multivariate analysis showed that alpha-fetoprotein(AFP)≥400 ng/ml(OR=3.510,95%CI:1.528-8.064;P=0.003)and tumor microvascular invasion(MVI)(OR=2.769,95%CI:1.143-6.706;P=0.024)were independent risk factors for early recurrence of single large hepatocellular carcinoma.Survival analysis showed that early recurrence risk factors significantly reduced recurrence free survival(RFS)(AFP≥400 ng/ml,χ^(2)=23.038,P<0.001;MVI positive,χ^(2)=10.554,P=0.001)and overall survival(OS)(AFP≥400 ng/ml,χ^(2)=14.336,P<0.001;MVI positive,χ^(2)=10.481,P=0.001)in single large hepatocellular carcinoma patients.Conclusion AFP≥400 ng/ml and MVI positive are independent risk factors for postoperative early recurrence in single large hepatocellular carcinoma patients.