实用肝脏病杂志 ›› 2017, Vol. 20 ›› Issue (1): 93-96.doi: 10.3969/j.issn.1672-5069.2017.01.024

• 肝癌 • 上一篇    下一篇

肝细胞癌患者外科手术根治术后生存分析

张杰, 段伯焕, 朱功兵   

  1. 830000 乌鲁木齐市 新疆医科大学第一附属医院急诊外科(张杰,朱功兵);
    解放军第474医院23临床部(段伯焕)
  • 收稿日期:2016-08-20 出版日期:2017-01-20 发布日期:2017-02-10
  • 通讯作者: 朱功兵 ,E-mail:702577257@qq.com
  • 作者简介:张杰,男,39岁,大学本科,主治医师。主要从事肝癌临床诊治研究。E-mail:15099171693@163.com

Affecting factors of survival of patients with hepatocellular carcinoma after radical surgical resection

Zhang Jie, Duan Bohuan, Zhu Gongbing.   

  1. Department of Emergency Surgery,First Teaching Hospital,Xinjiang Medical University,Urumqi,830000,Xingjiang Uyghur Autonomous Region,China
  • Received:2016-08-20 Online:2017-01-20 Published:2017-02-10

摘要: 目的 探讨肝细胞癌(HCC)患者行外科手术切除后5年生存情况的独立影响因素。方法 收集我院2008年10月~2010年10月收治的112例接受外科手术治疗的HCC患者的临床资料,行腹部CTA检查,观察患者相关临床指标,运用Cox风险比例回归模型进行单因素和多因素分析,得出独立影响因素,运用Kaplan-Meier 法和Log-Rank 检验比较这些因素在生存曲线分布上的变化情况。结果多因素Cox回归模型分析结果 显示,微血管浸润、肿瘤数目、肿瘤大小、肿瘤细胞分化程度和术后行肝动脉灌注化疗栓塞术(TACE)为影响此类患者生存情况的独立影响因素,其OR值分别为2.61、2.57、2.01、1.37、0.31,Kaplan-Meier 法和Log-Rank 检验显示38例TACE治疗组1 a、3 a、5 a累计生存率分别为90.6%、83.2%、80.5%,显著高于74例未行TACE治疗组的88.2%、41.5%、30.9%(P<0.05)。结论 肝癌根治术后给予TACE治疗可提高HCC患者生存率,延长生存期,有助于改善患者预后。

关键词: 肝细胞癌, 外科根治术, 生存分析, Cox回归模型, 肝动脉灌注化疗栓塞术

Abstract: Objective To investigate the independent affecting factors of survival of patients with hepatocellular carcinoma (HCC) in five years after radical surgical resection. Methods A total of 112 patients with HCC after radical surgical resection in our hospital between October 2008 and October 2010 were enrolled in this study. Possible prognostic risk factors were obtained through clinical observation. Then,the univariate and multivariate survival analysis were performed using Cox regression model. Based on the multivariate analysis Results , we compared the changes of survival curves between independent factors using Kaplan-Meier method and Log-Rank test. Results Multiple Cox regression analysis showed that there were five independent factors affecting the prognosis of patients with HCC in five years after radical surgical resection,which were microvascular invasion(MVI),the mass of tumors,the maximum diameters of tumors,histological differentiation,transcatheter arterial chemoembolization(TACE),and the OR were 2.61,2.57,2.01,1.37 and 0.31,respectively. Kaplan-Meier method and Log-Rank test Results showed the cumulative survival rates at 1 a,3 a and 5 a in 38 TACE-treated patients were 90.6%,83.2% and 80.5%,much higher than 88.2%,41.5% and 30.9%,respectively,in 74 patients without TACE treatment (all P<0.05). Conclusions The TACE treatment can improve the prognosis of patients with HCC in five years after radical surgical resection.

Key words: Hepatocellular carcinoma, Radical surgical resection, Survival analysis, Cox regression model, TACE